Shocked...Confused...& Terminated=SAD "(

Nurses General Nursing

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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

Specializes in Peds/outpatient FP,derm,allergy/private duty.

What a jerk! Having worked in places like that - there are many people who would've done it and told their friends later how they were supernurse to the rescue. I've seen some real hair raisers. You may be the first person to have refused based on your state scope and he had a tantrum.

I'll bet his malpractice carrier would have a giant cow if they knew he thought "standing over watching" someone do anything makes it legal. It doesn't. Good on ya! Sorry for how it went down, though.

Specializes in Clinical Research, Outpt Women's Health.

So sorry about your situation. Sounds like you did everything you could.

Specializes in LTC, assisted living, med-surg, psych.

Wow, even for an RN, pushing IV atropine is scary....but in a clinic setting with no cardiac monitor? I'd have done exactly as the OP did and made the MD do it himself. As it is, she has a case for wrongful termination, as well as assault and battery against the good doctor for pushing her down. His reaction was way out of line.

Specializes in Intermediate care.

If your an RN atropine IV should be in your scope of practice. May not be something you do routinely in urgent care, but it still can be done.

I work on a cardiac floor, and if i get an ortho patient, i don't refuse to take care of the patient because "it is out of my scope of practice"...because it is in my scope of practice, i'm just not used to it.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
If your an RN atropine IV should be in your scope of practice. May not be something you do routinely in urgent care, but it still can be done.

I work on a cardiac floor, and if i get an ortho patient, i don't refuse to take care of the patient because "it is out of my scope of practice"...because it is in my scope of practice, i'm just not used to it.

The OP has already said she is an LVN. She is not being a weenie, it actually IS out of her scope of practice.

Specializes in Med/Surge, Psych, LTC, Home Health.

I'm just not understanding why the doctor didn't just do it and have you do something else while he pushed that med. Really sounds like HE totally lost his cool and just blamed you for it, because he can.

Specializes in prehospital, ER, critical care transport.

Atropine IVP for the vasovagal syncope?

Sounds like a stellar operation all around.

Run, and don't look back.

Yeah, What the heck was up with that order for atropine.

Seems like that Doc didn't bother to know exactly what was to be treated.

Glad you are out OP, and even more glad that at least there are some co-workers somewhere that will help a guy out! What the heck happened to that everybody???? We need to support each other when this crap happens to one of us.

I thank her pals in backing her up and getting her set somewhere else.

Specializes in Urgent Care, MedSurg, SNF, ER..

Hi Altra,

I appreciate your response. This was another reason why I actually posted this as I stated in my main post that I know I am not the most experienced nurse in situations like this and I felt there was potentially more I could have done.

The reason why IV access was not initiated at first was because I need an order by the Provider in order to begin that. The patient was a 21Yo F with a C/O of nausea. She denied chest pain, headaches, sob, arm pain, etc. Denied a past medical hx or family hx as well. At least that was the data collected by the MA. The provider had not even seen the patient yet. Generally though phenergan is normally what is ordered for this CC. Glucose was 78. I checked her glucose while the Dr. was assessing the patient. Her pulse was steady although low. Her BP was low too, however for her height and weight did not seem fatally out of normal limits. The Dr. has stated prior that he should be brought to a patient before EMS is called if he is on site. Perhaps I should have set up the EKG. I opted not to until the Dr. entered because I wasn't sure if the Dr. would have wanted that immediately; I do understand that this of course would have eventually been needed. Again that is something I will probably do if this happens again.

Again I appreciate your feedback.

Respectfully,

NrsLucky

Specializes in Urgent Care, MedSurg, SNF, ER..

Thanks for your feedback. I am going to do my best to move on and learn from this experience. I really tried to talk to the Dr. He just didn't want to hear in anyway that his actions were wrong. I worked there a decent amount of time and for him to just terminate me that fast because of his ego shocks me. I do not want to subject myself to his name calling again so I will simply walk away as you suggested with my head held high. If he ever wants to reach out and apologize great, but I am not going to seek him out first. I do not like being called an "ignorant piece of work" or anything like that.

Thanks agian,

NrsLucky

Very sorry to hear you went through that! Sounds like the doctor acted irrational! I would get a lawyer for assaulting you... I guess I'm just the kind of person that like revenge though...

Specializes in prehospital, ER, critical care transport.

It's not revenge to defend yourself.

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