Dear Nurse Beth, On my first month on my own, I was incredibly stressed and overwhelmed. Ultimately, I made a pretty big mistake (MD ordered to D/C Lasix drip. Acknowledged the order but didn't do it) It ran overnight and when the MD rounded the next morning, she was furious. Luckily the patient did not die. I damaged his kidney function, but he was already very sick to begin with. I also had a needlestick accident. My manager was questioning my ability to be a safe nurse, so she placed me back on orientation for about another month. But I did not improve enough, so they gave me the option to resign or to be terminated. I elected to resign. All of my coworkers thought that placing me as a new grad on my unit was a bad idea to begin with. I was able to find another job in about a month. This time it was in a clinic. This was more of a case management role, in which I manage client cases. They initially started off training me pretty well, but things went to hell when staff members went on medical/stress leave. 2 nurses went on stress leave and 1 quit. My manager and the remaining staff started handling the rest of the cases. I believe training us got put on the backburner, and damage control became the priority. I was still assigned to a nurse and tried to help her and learn along the way. But all the other nurses were on edge with the additional caseload, and I believe it compromised my training. My nurse tried to help me, but with her additional caseload, it was difficult for her. Everyone had been putting in extra hours to compensate for the increased workload, including me. For the past month, I had been averaging 100 hours per pay cycle. Because there was still a lot of things I didn't know, I ended up making quite a few mistakes (which my team leader told me was okay. She told me to not be afraid to make mistakes because that is how we learn, and be more confident and independent). The turning point is where I compromised a client's case because I did not know that after surgery, the patient had to start taking certain medications. The patient did not get her medications, and it messed up her case. She was trying to have a baby and was on a time crunch. My mistake delayed her potential to have a baby right away. I realized my mistake when my nurse was going over another similar case with me. As soon as I realized it, I reported it to my nurse. I took responsibility for it and owned up to it. Naturally, my nurse was very upset. She reported it to the manager, who reported it to the higher-ups. As soon as I saw an HR Rep, I knew that I was done. They terminated me. My manager and team lead told me that they fought to keep me as hard as she could, but they could not save me. They also told me that if I ever needed a reference, I could use them, because they believe I'm really smart and will be a wonderful nurse, once I find my niche. I know I did the right thing by reporting my error. I know that if I waited, the situation would be much worse. Is this job even worth including in my resume? I feel incredibly disheartened right now. I was only at the clinic for about 2 months and got terminated so fast. I was only at the hospital for about 6 months before that. I'm starting to question whether or not I can be a good nurse. I haven't been in a hospital setting for a while, and am worried that nobody will hire me because I don't have a year of experience, and am worried about repeating the same mistakes I made in my previous jobs. What do I do?

Dear Disheartened, I am so sorry and I can't begin to imagine how devastating this has been for you. I think every nurse who reads this will be affected because "there, but for the grace of God, go I". We have all made mistakes we have had to process and live with. You were honest and took responsibility. People (the public) do not realize the enormous responsibility nurses have coupled with the fact that nursing school does not prepare you for that responsibility. Work conditions can be unimaginably stressful as you describe so well. In new jobs, and every day on every shift, it's often "sink or swim"- but that is no way for an organization to ensure patient safety. I believe new grads in acute care need one year of a residency, similar to a medical training model. Putting you in a case management position with six months of nursing experience is setting you up for failure. My hunch is that you are a diamond in the rough. You need support and the right setting. I like what your manager said, "they believe I'm really smart and will be a wonderful nurse, once I find my niche." You are no longer a new grad, you have had 2 jobs in one year, and you are unemployed. I would look for a job that is lower stress as you build your confidence. Your two immediate goals are to: Get a job Stay employed for one year Here are some ideas- is there a correctional facility in your area? It may be less stressful clinically. I haven't worked in one, and those that have may want to chime in- but I do know it's not acute care, which is a level down in intensity. Outpatient surgery clinic or pre-op... It can be very busy, but it's repetitive work which can mean less room for error. Behavioral Health unit. Fewer clinical procedures and builds a different set of skills. Are you a communicator? I'm calling on the allnurses collective wisdom and help here for ideas for you. Fellow nurses, what do you suggest? Thanks in advance, friends.

Terminated After Two Months!!

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation! Nurses Nurse Beth Nursing Q/A

You are reading page 5 of Terminated After Two Months!!

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nurslaura

3 Posts

next place u go to interview, ask more questions. your experience in these first 2 is actually very good, u learned importance of triple checking that u have transcribed, and also carried out the order, trust me u probably wont forget again, and u also learned im sure about some situations that you dont want to be in. ask about their nurse to patient ratio, look online for reviews from former employees, it takes a while to find an actual good position..try to find out why they are hiring, is it a revolving door because they have many issues or are they opening a new unit..dont be discouraged, and remember, you dont have to put up with being in a position that you dont feel safe, that your license is in danger or you are in danger of making a mistake..you are your best advocate :) good luck :)

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frenchieRN

3 Posts

Specializes in LTC, Med/Surg.

my first Nursing job was Long Term Care / Rehab and it taught me basic and fundamental nursing skills - prioritization, delegation, and to be around patients and build rapport. It eased me into patient care and bedside nursing and I am very grateful for the year I spent there. My current (second) nursing job is in acute care / Med-Surg and I definitely seen where LTC helped me build skills and prepare me for a faster paced setting. I have been here 3 months and I believe I wouldn't have adapted to this setting as quickly as I have if I hadn't been in LTC first. I believe 100% that LTC/SNF/LTAC is the best 1st job out of nursing school.

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Atomiccafe

9 Posts

which school did you graduate BSN? Did you study BSN right away or where you from the Associates RN program?

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she244

158 Posts

I also agree with this post. Owning up to mistakes in Nursing is an attribute to being a good Nurse and being concerned with your patients. All Nurses have to work and learn by finding the area that fits you and you are a good fit for. Long Term Care is a slower pace where you will find older Nurses who may have the teaching skills to show you at a slower pace about prioritizing what you have to do at the moment. Case management is also a large part of Long Term Care. Good Luck and Best of Wishes to You!

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Garden,RN, ASN, RN

143 Posts

You are right! I would think a properly structured residency would not only be good for the individual nurses but also for recipients of care.

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Alex_RN, BSN

335 Posts

Ruadh said:

As a 'second career nurse' I spent about 1 1/2 years in LTC...

Plus, you get to know your patients over time and learn from the repetition and case histories.

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BeenThere2012, ASN, RN

863 Posts

Specializes in PICU, Pediatrics, Trauma.

Quote

What stands out to me is that not only did she/he miss that the lasix gtt had been d/c'ED, but so did the night nurse if it ran until the next morning (which it sounds like it did since she said it ran "overnight"). I hope there have been some changes as a result of that. We've had issues with continuous fluids and drips not being stopped accurately, so now at change of shift both RNs review the continuous meds orders, review the pumps, line trace, etc. I personally think the eMARs should have an "overdue" alert if a med is not stopped (like it does if a rate isn't changed or a med isn't started).
I also will stop the drips immediately before I forget or if it's set to be d/c'ED at a specific time (such as 8 hours after the IVF was started) I will set an alarm on my phone so I don't forget (I say the hospital is a black hole where I lose all perspective of time).

So true, and I agree with your advice. Over time, we all develop our ways of reminders and ways to avoid errors. WE ALL make errors from time to time...Come on...Admit it, right? But by the Grace of God is so true for us all. Hopefully, we don't make huge ones.

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BabyFood26

203 Posts

Specializes in Home Health, Mental/Behavioral Health.

DogWmn said:

~ scary So many schools today don't have enough clinical hours ~

Thanks you!! And I also wonder how well her fellow grads are doing. There's SUCH a saturation of schools who seem to be ill-equipped or not even so much interested in providing adequate training. It's every eager learner for themselves :confused:

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marilynpyles

5 Posts

Extremely well written!! Nursing as a profession needs a overhaul.

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Patrick61

1 Article; 2 Posts

Hi,

I've been a licensed nurse approximately 25 years. I also have 3 college degrees. I'd suggest home health nursing, or hospice nursing. That might reduce some of the stress, etc.

Best Wishes,

Patrick

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Ann27

6 Posts

Hi TheCommuter,

I too am a Type B personality, and am hoping for a slower-paced environment when I get out of nursing school. Do you have any recommendations? I am starting to worry about what I am reading about working in hospitals.

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