RN Suspended

[j0ginder]

I need some insight from my fellow nurses,

a little bit about me I have been a nurse for a year and a half now, I came from a nursing home with subacute experience then transferred to a childrens hospital and was hired on the pediatric ICU floor. I was so excited to start this job and in the interview they made it seem like I would get tons of learning experience even including basic core classes.

So fast forward four months later, I was placed on an improvement plan based on my skills and performance, I lack a lot of self confidence and required reassurance for simple basic skills such as putting in an OG tube or leveling an ART line or even documenting because this unit does hourly charting for trends. The problem is they give you 40 shifts to learn everything and anything from your preceptor before determining you are able to work alone. by my 20th shift I was placed on this plan. I agreed to it because it has been a bumpy road with me first trying to improve my assessment skills in pediatrics and also learning drips in ICU setting. I love the fast paced and I have had my good days and bad.

SO today I walked into work and I was drawing up Ampicillin and it was ordered 125mg, I was drawing up the medication when the Nurse I was following asked me what is the safe range dosage for this drug, I thought about it and did not know so I didnt want to make a guess, I told her I did not know and she said lets look it up together, we did and it the drug was in the safe range, then while documenting every nurse I have been with states just drag and drop the charting and adjust accordingly, so with unintentional learning I did the same and was sure to change anything new in my assessment, I had accidentally documented that the NJ was a 45fr with 6cm out in one of my hourly charting, when it should have been 6fr 45 cm out, I pointed out my mistake to my preceptor after saving and told her I would go back in the documentation to change it. I was later pulled in to my supervisors office and she stated since I am on a performance plan already she was putting me on suspension for three days and she would call me back monday to let me know if she decides to let me continue. She stated she felt I was an unsafe nurse, I felt so imcompetent. I feel no matter how hard I try on the unit I am always behind other nurses. I just feel in a way it is unfair because when she hired me she knew I did not have pediatric or hospital experience, also their have been many new nurses that I have point blank seen drag and drop charting and document incorrectly and they do not go back to fix it because they are lazy. I am honestly heartbroken and I dont know whether I should just resign rather than hear her say we are letting you go.

[TheCommuter, BSN, RN]

Welcome! Perhaps the PICU might have way too much acuity for your current nursing abilities and skill set?

I'm not suggesting that anyone give up on a dream...I am presenting the idea that perhaps a less acute floor (e.g. med/surg, ortho, progressive care, acute rehab) might present an avenue to further build your procedural, clinical and thinking skills.

Good luck to you!

[Marisette, BSN, RN]

i'm so sorry you are going through this. I admire your courage for taking a risk and leaving the subacute area to work in ICU. A suspension sounds quite serious. It's not like a verbal or written notice. Your next mistake may cost you this job. I would speak to the supervisor and see if there are other areas within the organization where you can develop skills in pediatric care that is not in the ICU. You may want to try the ICU again in the future, but it sounds like this is not the area where you should be now.

It takes some of us longer to learn than others. Some employers will go the extra mile to make sure their nurse learns, but I don't know how serious your mistake is, or if you keep making the same types of mistakes repeatedly. It does not make you a bad nurse, but you may not be ready for this job now. Granted they have not lived up to their part of the bargain, and they may be unfair. Some employers are like this and there is not much you can do. Be kind to yourself, and pursue greener pastures. I know this must be very difficult.

[quazar]

Oh dear. I was hired to a pediatric ICU right out of school, and not only did my preceptor eat me alive (she had a rep for doing that, too), but I was so terrified and nervous that my confidence was just shot and for the life of me I just could. not. get. organized. I was put on an extended orientation too, and decided only a week or so later that it just wasn't worth it. I was having trouble sleeping, I was driving into work with a knot in my stomach every day, and I was anxious all the time. I hated it. I transferred to a different unit with a slower pace, and it was much better. It took me a really long time to get over that whole situation. The embarrassment of not being able to handle it, number one, and number two, the anger at being paired with a preceptor who had a rep for running off new nurses when I might have been different with a nurturing preceptor. Who knows. It has been a long long time now, and hindsight being 20/20, I can say without a doubt that everything that happened there and the road it led me down happened for a reason and I am where I'm meant to be.

ICU for an inexperienced nurse is so hard. If you're having that hard of a time with it, please, transfer somewhere else and learn time management and charting skills and just how to be a good bedside nurse first. It really will help, and you'll be happier in the long run. Trust me on that.

[LadyFree28, BSN, LPN, RN]

Had the same issues as my PICU experience...

They made it seem as though I would get a TON of classroom time, they knew I came from an out of hospital setting as well; I knew I needed a LOT of transition time and the PICU was something I saw 5 years down the line as a goal, not an initial hospital job, but I'm one of those people that chicken out, so I bit the bullet and left after 8 weeks orientation, stamped with the "not a good fit."

It can be a blow to the ego, and it can hurt; however, if they tag you with the "not a good fit," be prepared to work your way back up again; it won't be the end of the world, either.

I ended up post-PICU became a supervisor in a nursing home, then stayed there and ended up working at a post-acute pediatric facility, became a supervisor there, then returned to the hospital setting as an ED nurse-I've been at this position for a year.

There's life after a suspension/firing.

[jadelpn, LPN, EMT-B]

There is a world of difference between peds and adults. Add to that PICU and it is a specialty that takes a really long time to develop a skill set at the critical level.

Maybe see if you can transfer to a general pediatric floor. This way, you get a sense of how to take care of pediatric patients who are acute, but not critical.

Best wishes

[April1abbott]

Stories like this make me hate nursing! All you need is more time in training. But no they don't invest in staff. Just constant ********.

Ask for a meeting and get more time to train. That is your license in jeopardy. You have some rights.

[Been there,done that, ASN, RN]

YOU are not incompetent. The facility and your orientation is. The powers that be are trying to push you into the role.. to make money for the MAN.

During a decent orientation... in a decent facility..a write up, let alone a freaking suspension.. does NOT happen. You should have a weekly evaluation to assess your progress with a plan to assist YOU to succeed.

To Hades with this joint ..resign and find a facility that will support your transition.

[suga_junkie, BSN, RN]

Hough

[Been there,done that, ASN, RN]

Welcome! Perhaps the PICU might have way too much acuity for your current nursing abilities and skill set?

I'm not suggesting that anyone give up on a dream...I am presenting the idea that perhaps a less acute floor (e.g. med/surg, ortho, progressive care, acute rehab) might present an avenue to further build your procedural, clinical and thinking skills.

Good luck to you!

100% disagree Commuter. It's not her.. it's THEM. She can do it if given the proper orientation.

[xtinamtnz]

I work on a pediatric oncology unit that is like a step down ICU. You can expect to get a septic kid, give chemo, a bolus, blood products, and new antibiotic all in one shift. When I first started I had no peds experience either. I was a new grad and so nervous. I had a similar experience lacking self confidence. I felt like eyes were always on me. I also had to extend my orientation to a few more shifts too. I want to say up to 6 months in I was contemplating quitting. I was already on my own at that time, I was constantly stressed. My time management sucked. I felt in certain situations I lacked support from other resources like RCP's or physicians. I'd go to work with heart palpitations.

However, I listened to advice and stuck it through. I don't think you should give up, PICU is hard but what makes it harder is lack of support from your peers. My coworkers are awesome. I love them. That is the main reason I'd never walk away. Maybe PICU isn't for you just yet. A classmate of mine had a similar experience at my pediatric hospital too and it sounds like you have some issues with coworkers. If I were you I'd look for work on a different unit. No point in working with people who don't support you and encourage you to cultivate your skills. Everyone's right, pediatrics is a tough population to adapt to.

Don't let this difficult time get to you, you earned your license and you are competent!

[HouTx, BSN, MSN, EdD]

Lots of great advice & empathy for OP - I'm always so proud of AN'ers ability to respond appropriately to just about any situation. You guys ROCK!

However, one of OP's statements was a bit disturbing. I don't think that there's enough awareness that the "drag & drop" practice (AKA, cut & paste) is a VERY BAD PRACTICE habit. Many organizations (like mine) not only have explicit policies prohibiting it, but have taken programming steps to try to prevent this in the EHR. We've found this specific practice to be directly related to patient harm in many different situations - because it becomes the source of inaccurate information which is then used to make subsequent clinical decisions.

If you're doing it, best case scenario... you're probably violating policy & worst case... setting yourself up for significant problems, including major clinical mistakes, termination & potential impact on your license. Literally, it can (and has) result in charges of fraudulent documentation. Please be very cautious.