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.
I am unsure of what to do now. I was called by my friend the NP from my prior job who told me that the Dr. wanted to talk with me. I kindly declined because I do not like confrontation. The Dr. snatched the phone from the NP's hand and told me that he wanted to speak with me and that there were things that needed to be worked out. He said that "things were said that weren't necessarily meant" and that he expected me to be in his office tomorrow in the AM. He assured me that there would be no yelling but that this would be a "pleasant" meeting. I did not know what to say...so I said okay. He passed the phone back to the NP who told me she would call me later. I later found out by calling my friend who is an MA there that she informed the Office Manager as well as the NP that the Dr. shoved me off of my heels onto my butt and into the exam light. She said that she was asked by the NP because all of the MA's who witnessed it were talking about it as the clinic "Gossip". She said that my friend the NP pulled the Dr. inside her office along with the Office Manager and they had a "heated debate". That so far is all I know but she did say that she think based off of the small bits of conversation she was able to hear through the room that he plans on "apologizing" and offering my job back. I don't know if I should show up or if I should just decline. He said before he ended the call "Don't disappoint me or make me come to you.". This worries me...immensely.
It would worry you less if you would seek help from an attorney. Follow the advice of your attorney. If I have ever seen grounds for wrongful termination it is here. The doctor is backpedaling because he wants to squash your obviously justified actions. Don't be foolish. Follow the advice of your attorney and stop posting about the situation on a public bulletin board.
Your message is completely full of wisdom and well recieved. Thank you so much. I did not even think in that mindset at the time this transpired. I think just from being in this office/clinic setting I was used to these protocols that the RN told me to follow and I simply forgot how to critically think as I was trained to do. Thinking back now I can't believe I would not have administered 02 ASAP or connected her to a cardiac monitor to see exactly what her heart was doing. This seems like Emergency 101 when I think about it. I think my half thought out rationale was that she didn't really display signs of poor perfusion nor did she have a any documented signs of an altered mental status, chest pain, shortness of breath, hypotension, or other signs of shock during her intake. Her pulse was 50 and 02 98% per pulse ox btw.
I will definitely make sure that I am more equipped to act appropriately the next time I am faced with a situation like this. Again thank you for your advice.
I will take everyone's advice. I'll contact an attorney tomorrow. Im just concerned about the damage this may cause to the relationships I have with a lot of people. Thanks for everyones advice...n please say a prayer and cross your fingers for me...I think I'm going to need it if I'm going to try and go against one of the powers that be...
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I'll say a prayer for you Nrs Lucky. This doctor sounds more and more like a loose cannon with some very serious control issues. It also sounds like the drama that seems to go on there is not a good environment to be in . . .don't let him intimidate you!! Best wishes! :)
Don't necessarily second guess yourself too much either based on internet advise.
We weren't there..so I feel it is impossible to really say with any good certainty whether or not your actions were the right ones or not...due to lack of complete information.
If her spo2 was 98% with no s/s of sob or mi or poor perfusion. I don't know that 02 would be my first thought in a situation where you had to act quickly...nor would I have taken the extra time taken to find and hook up the EKG machine...(you can tell with a quick listen if her HR is regular or not) (Perhaps after she was stabilized) Afterall, who is watching the patient while all that is going on. What if she arrested?
I might be inclined to call 911 though (even if it got me in trouble) Again...you only have so much time in a major emergency.
You have to carefully prioritize what you do with that limited time. If the patient made it through then I guess you all did ok.
Wasn't their anyone else but you and the Dr who could have started that Atropine in the office...thats who I would have called in. Are you even trained in how to start IV access? Proficient at it? I KNOW that personally since I never do those, I doubt I could have gotten access.
I assume the ammonia packets are those things you have people who fainted sniff to wake up? Dont know alot about those.
Dont spend too much time dwelling on this....learn what you can from it and move on!
Do not, Do not, Do not go to that meeting!!!!! I can't say this enough. Call the office back and let that jerk know that the only meeting you will attend is one with your attorney present. This guy not only is backpedalling but he also knows that he's in major legal trouble for putting his hands on you. File the police report immediately!!!!! Call an attorney immediately!!!! Do not let this go on any longer.
Am sorry this happened BUT, like others have posted..best thing because I personally would not want to work for an MD that thought it was ok for anyone to practice outside their scope...that is scary and illegal so you did the right thing.
Do not, Do not, Do not go to that meeting!!!!! I can't say this enough. Call the office back and let that jerk know that the only meeting you will attend is one with your attorney present. This guy not only is backpedalling but he also knows that he's in major legal trouble for putting his hands on you. File the police report immediately!!!!! Call an attorney immediately!!!! Do not let this go on any longer.
Specializes in Clinical Research, Outpt Women's Health.
"her pulse was 50 and 02 98% per pulse ox btw"
Uh huh. Doc panicked. Young women in medical situations often get a vagal response. Believe me, 10 years in a gyn clinic taught me that. All that intervention such as an IV was way cart before the horse.
However, since you were not harmed I don't see what an attorney will really get you. While you could file charges perhaps he is genuinely remorseful and really what would that accomplish.
I would meet with the doc with the manager present and give him a chance. I would insist the whole incident be documented and that you get a copy in case of any retaliation.
Then, and only then, should you decide if you return. If so, you will have a job for life with that to hold over them! Always looking on the bright side...........
Do not, Do not, Do not go to that meeting!!!!! I can't say this enough. Call the office back and let that jerk know that the only meeting you will attend is one with your attorney present. This guy not only is backpedalling but he also knows that he's in major legal trouble for putting his hands on you. File the police report immediately!!!!! Call an attorney immediately!!!! Do not let this go on any longer.
I second this. The only way I'd go to that meeting is if my attorney was standing next to me. And I would not hesitate to let the doctor know that.
NrsLucky
28 Posts
I am unsure of what to do now. I was called by my friend the NP from my prior job who told me that the Dr. wanted to talk with me. I kindly declined because I do not like confrontation. The Dr. snatched the phone from the NP's hand and told me that he wanted to speak with me and that there were things that needed to be worked out. He said that "things were said that weren't necessarily meant" and that he expected me to be in his office tomorrow in the AM. He assured me that there would be no yelling but that this would be a "pleasant" meeting. I did not know what to say...so I said okay. He passed the phone back to the NP who told me she would call me later. I later found out by calling my friend who is an MA there that she informed the Office Manager as well as the NP that the Dr. shoved me off of my heels onto my butt and into the exam light. She said that she was asked by the NP because all of the MA's who witnessed it were talking about it as the clinic "Gossip". She said that my friend the NP pulled the Dr. inside her office along with the Office Manager and they had a "heated debate". That so far is all I know but she did say that she think based off of the small bits of conversation she was able to hear through the room that he plans on "apologizing" and offering my job back. I don't know if I should show up or if I should just decline. He said before he ended the call "Don't disappoint me or make me come to you.". This worries me...immensely.