Published Feb 1, 2012
NrsLucky
28 Posts
i would like to start off by stating that i have never been terminated from any job position i have ever held...until today. i have always had a great reputation at work and never had any issues at any of my jobs...including this specific job. i am going to be very brief and vague in my description in order to avoid possibly giving to much information. with that said...i am just going to briefly give a description of my actions which apparently led to this termination in order to hopefully recieve feedback and some direction. here goes...
today only 30 minutes into my shift at the immediate/urgent care facility i work at part time i was interrupted in the middle of carrying out an order by the physician which was to apply a wet to dry dressing on a patient. i didn't even start applying the dressing yet when the medical assistant barged into the room screaming for me to hurry up and follow her. i asked my patient if she would be okay in waiting here and had her sit completely back on the exam table before leaving. as i followed the ma out of the room i ushered for another ma who was standing in the hallway looking at me to stay with the patient and make sure she was okay until i returned. as i followed the ma down the hall i began asking her to tell me what was wrong. all she kept repeating though was "i have no idea what happened i left her alone for only 5 minutes." when i entered the room the patient was slumped in her chair with one other ma and a receptionist propping her up. she obviously had a vasovagal response to something. i immediately had the ma's assist me in laying her down flat on the floor as i elevated her feet and pulled an ice pack from the drawer to place behind her neck/head. i told the receptionist to go and get the np or md and she stated the np was at lunch and the dr. was doing an exam. i reassured her that it would be okay to politely nock on the door and let him know what was happening. she hesitated before departing. i than grabbed an ammonia tab and had an ma begin waving it under the patients nose in order to try and awake her. i than did a rapid assessment. the patients airway was patent with no signs of obstruction. breathing was normal and even with no shallow or labored breaths. patient was perl. her bp and pulse were low. there were no physical signs of trauma or of a potential allergic reaction. the dr. entered the room, assessed the patient, asked me what happened, and than had me start an iv. he had an ma retrieve the atropine and than gave me the order to administer the medication. i asked if he meant im but he was clear that it was through the iv. i politely refused as this was not in my scope of practice. he looked at me as if i had spit in his face. i tried to explain myself but he rebuked me and asked me to leave the room. i went back to my patient completed my order and continued with my work. i was called into his office 45 minutes later and was informed that i was being terminated for insubordination with a possibility of neglect. there was a huge debate that followed but i will not get into that. it ended with the office manager and the np stating to me once the dr. left the room that they were sorry and that i did nothing wrong. they even said that i can use them as a reference and they would both call around to other urgent care's who had an opening.
i have been there 1 1/2 years. never have i been written up or anything. i am so sad. i have no idea what i did wrong. on a good note; i already was offered a job at a small private urgent care by a pa who partially owns the clinic. in addition i also currently work for my local hospital part time. he was contacted by the np at this job.
i want to know if i should have done something different in these circumstances in order to have avoided this outcome. i admit i am not the most experienced in dealing with situations like this so i know my former coworker who is an rn probably would have been more helpful...but i did what i could... any feedback would be appreciate.
respectfully,
nrselucky
SuesquatchRN, BSN, RN
10,263 Posts
You did the right thing, except for defying God.
bols27
52 Posts
I am sorry if this is a silly question, but why was administering atropine IV per the doctors order outside of your scope of practice and IM is not? I am a nursing student so this is of interest to me.
agldragonRN
1,547 Posts
i am sorry if this is a silly question, but why was administering atropine iv per the doctors order outside of your scope of practice and im is not? i am a nursing student so this is of interest to me.
i am assuming the op is an lpn and cannot iv push.
op,
that md is a jerk and should know the scope of practice of his subordinates. good thing you already have other jobs lined up.
MN-Nurse, ASN, RN
1,398 Posts
It sounds like the OP may be an LPN?
qcc2011grad
47 Posts
I'm sorry this happened to you . It may sound like a clique but I'm a firm believer that things happen for a reason . I am also happy you got another job lined up and most importantly you have your license and are practicing within your scope of practice.
caliotter3
38,333 Posts
You are wise. The MD overreacted. Glad to hear you are able to move on. You should be able to successfully explain this away in the future. Best wishes.
I feel the same way. The only thing that has me confused is that I told the Dr. that I was not allowed to administer IV meds and he stated coldly "I know what you can and cannot do. But I am right here in front of you observing. So give the medication." I told him I could not and he literally pushed me backwards onto my butt and said "get out of this room and out of my sight." I am still at a loss for words.
Creamsoda, ASN, RN
728 Posts
Why couldnt you admin the atropine? If your an RN, you should be able to. Or were you just not comfortable? Atropine is for symptomatic bradycardia, thats why he wanted it. If you are an LPN, I understand but if you are an RN there should be no reason you couldnt give it.
If he put his hands on you to shove you backwards on your butt, that is battery. You should press charges. Fix his God wagon.
Unfortunately I am not an RN yet. Only an LVN. This is one of those times I really 100% wish I was an RN. But until I can get accepted into a bridge program theres nothing I can do.