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 none.
Seriously? yeah, it was wrong, yeah, it sucked, but adrenalin was pumping and she was not injured so you want her to lay out the cash for an attorney when in all likelihood she will get nothing in return?

I so disagree.

Every situation is different and I am all for reporting true assaults, but i feel it was the adrenilen of the moment and trying to get to the patient more than anything. Wrong way to handle it? Absolutely! He knows that now.

Geez, if everyone here hired an attorney every time it was advised they could really make some bucks!

P.S. OP - awesome job getting an IV in during such a stressful time. Wow!

People have been killed during 'adrenalin moments.' Having been a cop in the service, I know. He needs to protect his rights and not get screwed again

"don't make me come down there to get you"??? this was a clear threat. do not follow any more of his "orders" and do not appear at his office just because he orders you to.

and don't be scared, if you stay away from him. you hold a lot of the cards here, and he's aware of it. i'll be he has had past complaints and may even be on double-secret probation with the medical board or his already, so he's scared. people who are angry are usually, at the base of things, afraid of something.

the atty will take this with fee dependent on what s/he wins for you, so never fear that you'll get the most possible. i know you're not in it for the money-- donate it to an anger-management program if you want to-- but this is the only way to get the attention of this kind of bully.

you shouldn't say anything more here until it's over but i hope you let us know how it works out!

Specializes in Pediatrics, ER.

Just wondering what happened OP. Did you go to the office?

Specializes in All Icus x Nicu/ Shock Trauma/flight nur.

OK Lucky,

I think I posted to you a couple of days ago, but I reviewed your posting and wanted to make a couple of comments. So you cannot start an IV, it's not in your scope of your practice right? Here are some questions I would have for the white coat. He know noting about her health history yet he ordered atropine? Did he do an ekg? I would have checked her blood sugar also. I would want to know what his rational was for choosing this medication, and if he was so concerned why didn't he start the IV and push the medication?

Did he have you put her on a cardiac monitor? Did the atropine help this patient? Did the doc return to check on her? If so I would have noted when she was medicated and ifand when he returned to reassess her, a also made a notation if he put her on a monitor. If he had enought time to complain and get you fired, did he also have enough time to do the right thing about this patient? I'm sorry this happened to you, you should have had a licensed person available to you for instances like this. It's all about the Money. Hold your heard up high and realize the doc you described we have all know our share of. In my opinion soulds to me your ata the very least owed an apology and your job back, but I wouldn't hold my breath. You didn't do any thing wrong, he was out of line so it seems to me. Good Luck, you will find another job and may find that you are happier there. FLTNRSE

I see your point...about adrenalin

I think the issue here is that she was fired for refusing to something that was not in her scope of practice.

Specializes in Psych ICU, addictions.

Hopefully the OP is being wise enough to refrain from posting more about this until the matter is resolved...then please, OP, come back and let us know how it all turned out! Good luck!

Specializes in Pediatric Private Duty; Camp Nursing.

Wow, I guess this OP got an attorney, since we haven't heard a peep! We can't all be left hanging like this!

Specializes in Post Anesthesia.

I'll get my fire extinguisher out 'cus I bet I get "flamed" but you just illistrated the argument I've always had for eliminating LPN/LVNs in acute care. Pushing atropine is an appropriate intervention and could easily have been life saving but the doctor has to figure out not only what is wrong with the patient, how to treat it, but who is or isn't the right flavor of "nurse" to carry out this intervention. As far as a "MA" I'm not sure in your state what thier scope of practice is, but the title "Nurse" should mean the same something whenever it is used. My opinion- an LPN/LVN shouldn't be working in an area where emergancy interventions/ verbal orders/ IV meds are likely to be happening. I would go as far as saying we may need a new title for those serving as a VN/PN in todays health care. I feel badly for everyone involved. It isn't your fault, but the facillity shouldn't be placing the doctor and the patients in a position where there is no skilled, licenced care giver present that can legaly follow the doctors instructions in the event of a crisis.

Specializes in none.
I'll get my fire extinguisher out 'cus I bet I get "flamed" but you just illistrated the argument I've always had for eliminating LPN/LVNs in acute care. Pushing atropine is an appropriate intervention and could easily have been life saving but the doctor has to figure out not only what is wrong with the patient, how to treat it, but who is or isn't the right flavor of "nurse" to carry out this intervention. As far as a "MA" I'm not sure in your state what thier scope of practice is, but the title "Nurse" should mean the same something whenever it is used. My opinion- an LPN/LVN shouldn't be working in an area where emergancy interventions/ verbal orders/ IV meds are likely to be happening. I would go as far as saying we may need a new title for those serving as a VN/PN in todays health care. I feel badly for everyone involved. It isn't your fault, but the facillity shouldn't be placing the doctor and the patients in a position where there is no skilled, licenced care giver present that can legaly follow the doctors instructions in the event of a crisis.

Yeah, I guess we monkeys shouldn't be allow to get next to any IV needles or EKG monitors. We might poke someones eye out. I think someone should tell the Veterans Clinics that LVN/LPN should be eliminated. In the two that I have gone to, LPN's run the place. Advance technology is nothing new to them. They state the IV's, take the EEG's, EKG's, Draw the blood, Take verbal orders, and handle codes. But we know that it is run by the government and the standers are low. That's why a LPN that works for the VA can practice in any state. I know an LPN whose office wall is filled with Government Certifications. When I work in one Medical Center for only heart and lung, I was certified in Critical care. Of course this was during the dark ages before computerized EKG's I remember the finale Exam. They gave you 25 stripes and you had to tell what rhythm the patient was in. length of each wave and if the rhythm was abnormal what would be the regular course of treatment. But like I said it was during a less enlighten age. when MS's and PHD's just sat on their hind quarters and barked.

I'll get my fire extinguisher out 'cus I bet I get "flamed" but you just illistrated the argument I've always had for eliminating LPN/LVNs in acute care. Pushing atropine is an appropriate intervention and could easily have been life saving but the doctor has to figure out not only what is wrong with the patient, how to treat it, but who is or isn't the right flavor of "nurse" to carry out this intervention. As far as a "MA" I'm not sure in your state what thier scope of practice is, but the title "Nurse" should mean the same something whenever it is used. My opinion- an LPN/LVN shouldn't be working in an area where emergancy interventions/ verbal orders/ IV meds are likely to be happening. I would go as far as saying we may need a new title for those serving as a VN/PN in todays health care. I feel badly for everyone involved. It isn't your fault, but the facillity shouldn't be placing the doctor and the patients in a position where there is no skilled, licenced care giver present that can legaly follow the doctors instructions in the event of a crisis.

That's just downright insulting.

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

☛reply to off-topic post removed☚

Specializes in Pediatric Private Duty; Camp Nursing.
I'll get my fire extinguisher out 'cus I bet I get "flamed" but you just illistrated the argument I've always had for eliminating LPN/LVNs in acute care. Pushing atropine is an appropriate intervention and could easily have been life saving but the doctor has to figure out not only what is wrong with the patient, how to treat it, but who is or isn't the right flavor of "nurse" to carry out this intervention. As far as a "MA" I'm not sure in your state what thier scope of practice is, but the title "Nurse" should mean the same something whenever it is used. My opinion- an LPN/LVN shouldn't be working in an area where emergancy interventions/ verbal orders/ IV meds are likely to be happening. I would go as far as saying we may need a new title for those serving as a VN/PN in todays health care. I feel badly for everyone involved. It isn't your fault, but the facillity shouldn't be placing the doctor and the patients in a position where there is no skilled, licenced care giver present that can legaly follow the doctors instructions in the event of a crisis.

I am an LPN and I have to admit that there's merit to what suanna is saying. I worked in a SNF and every now and then, someone would have an IV med, like vancomycin. My employer kept promising to hold an IV certification course but never would actually do it (we can only do IV meds if we are certified in my state; RNs have it automatically within their scope of practice). Several times I had such a pt, and I'd have to go running all over the place finding an RN who help me out. Like they didn't have enough to do already! More often than not, they'd make me wait and wait, and the meds were never done on time. Sometimes they'd just flat out refuse. I'd have to go to the DON for help and then I'd get lectured for not being more assertive and convincing these RNs to help me.

In my area, hospitals only hire RNs. We LPNs can do everything they can do, except hang blood, admin chemotherapy, do push meds (heparin is ok) and pronounce a person's death. Unfortunately, those are things that do come up in a hospital, so I completely understand why LPNs are not hired there. Nor would I want to spend my time running around pestering people to do my work for me.

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