Terminated over the phone.

[hellokitty9]

The other day I received a call from my DNS and she terminated me over the phone about a mistake I made the day before. I worked at the skilled nursing facility for 1 1/2 years as a relief nurse. I have been written up once within a few months of employment. Since then I have made mistakes, discussed it with the DNS and did not have any further write ups. The other day I had a total of 9 skilled patient load, which was nothing abnormal and was consistently busy-- and somewhat stressful. In room 36 there were two patients, one by the window (36W) and one by the door (36D). I got in report that 36W is going to discharge home in 4 days, she was independent in her room, alert and oriented, cooperative, ect. The patient was 7 days post op for a CABG where they used the femoral artery (can't think of the specific name), the patient had a dressing on her inner thigh that appeared to be clean, dry and intact. 36D had a fall at home, broke her hip and had surgery. She also had cellulitis on the affected leg and her dressing was saturated with clear sero-sang drainage to the point that it went through to her sheets. While changing her dressing I noticed redness around her staples as well, also markings from a sharpie demonstrating the area of redness- which was still within its proximity. I had an order remove staples and I promptly went to 36W and discussed the procedure with the patient, removed the dressing and the incision appeared intact and I removed the staples (some staples has some skin growing around it) and applied steri strips. Based on my assessment I thought that I was in the right, fulfilling my nursing duties and the patient was satisfied. The following day I received a call from the DNS stating that I had removed the staples from the wrong patient! My heart sunk. She explained that because of the risk she was terminating my position. Not to minimize the risk I caused to the patient, but I tried to explain my nursing assessment, however she did not seem consider or listen. I asked if the patient was ok, and she did not know, and stated that all she knew was that the surgeon was called. She did not have any other information. She also explained that being a relief nurse I need to triple check my steps-- and I explained that I am accountable for not referring back to the order and to which patient I was to remove the staples. I understand that there is risk to my mistake, such as the incision could dehisce, however I feel that I am competent as a nurse to judge if the staples were ready to be removed. I feel I would question the correct patient's order and may have called for a clarification. I feel that I may have been wrongfully terminated. The DNS did not give me the curtsy to come in and talk about it, it was over the phone, nothing in writing and I feel she is not being a professional advocate or respecting my professional integrity. I called her to schedule a meeting with her and she a agreed to meet with me next week. For my own peace of mind I feel like I need to explain this to her. She did not follow do process and I don't know if what she did was right. I feel she reacted with an emotional response because she learned about the incident probably 2-3 hours prior to calling with the news. What do you guys think????

[Isabelle49]

Was it really the wrong patient who staples were removed from?

Edited to add: The staples were removed from a wound that continued to drain ss fluid. To me, this would indicate that the skin edges were not closed well enough to remove staples. Am in Home Health and occ have to remove knee or hip surgery staples and if I find drainage or taught swelling, I call MD to delay removal of staples.

[hellokitty9]

Yes, I removed the staples from the wrong patient. Based on my assessment it seemed correct, but I failed to re-check the order and look at the name. So I was terminated for removing the staples from the wrong pt, but if I was to remove them from the right pt I would have second guessed it. I did not remove the staples with the pt that had ss drainage.

[caliotter3]

She may have been within her purview to terminate you but it should not have occurred over the phone. That was not professional. She should have called you in. The results could have been predetermined, but she could have heard you out before firing you.

[LPNweezy]

We all make mistakes, and that is definitely a credible reason to terminate someone. Just learn from your mistakes and find a new job and move on :) I don't really see a point in a future meeting with your DON, i doubt she will change her mind about the situation. And i agree, that was very unprofessional to terminate you over the phone. Just live and learn.

[ckh23, BSN, RN]

You made a mistake and they do happen. Thankfully no harm came to the patient. There really isn't too much you can do at this point. Maybe the DON will reconsider during your meeting, but I wouldn't get my hopes up. I think it sounds like they are covering themselves just in case something bad comes from what happened. However, they were within their right to terminate you even if it was over the phone.

[SharonH, RN]

1. You removed staples on the wrong patient which is a pretty significant error. Actually, it's two errors: a) a patient who should have had their staples removed didn't and b)a patient who should NOT have had their staples removed did.

2) You state you have had several other errors that did not trigger a write-up but you have established a pattern of problems.

3) You want to "explain" yourself. What is there to explain? You are having difficulty with accountability.

She probably should have given you the courtesy of telling you face-to-face but I don't believe it is wrongful termination.

The good thing about errors is that they usually inspire us to be more careful in the future. Good luck with your next position.

[Dalla]

Should you have been fired? Probably.

Should it have been over the phone? Definitely not - very unprofessional.

Should you meet with DON to discuss this matter? I wouldn't. Let it go and don't use them as a reference.

[blue heeler]

i think this is a good lesson. always check orders before doing dressing changes or staple removal.

[hellokitty9]

Thanks everyone for the comments, it's really helpful with processing what happened. I discussed with nurses I work with and they all agreed with me and now that I think about it it was likely because they knew me and didn't want this to happen to me. Getting an outside opinion has shown me that I wasn't fully taking accountability, whereas I thought that I was. I will definitely take this as a learning experience, and to remember the basics and not take short cuts. I think that I will call to cancel the meeting because now I feel like that I don't have anything that I need to explain, and state that I take full responsibility for what happened and that there isn't any reason to discuss this any further. I feel like I need some encouragement though....should I do this instead? Thanks again.

[netglow, ASN, RN]

kitty, you know what, I'd meet with her and totally acknowledge the error. You just want to be the professional. Don't "but, but I, I was thinking..." Just acknowledge, state you are unhappy about it all and really will be sad to not be able to come back. Let that sit, and see what she says. Surgeons get super-****** if anyone messes up a surgery -- not that you did, but some really, really look at what you did as a violation. Your DON is anticipating getting a "talking to" her/himself. So, what I am saying is just try to do damage control, maybe you can get a decent reference...

[79Tango]

Firing you over the phone was the easy way out for the DNS. You might want to just slip away quietly before you trigger a write-up to the BON. She might feel the need to teach you a lesson. Telling or writting "You take full responsibility for what happened" will not just end with her.