Terminated over the phone.

Published

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????

Specializes in Med-Surg.

Is this not like any other med error out there? Someone gives the wrong person the wrong medication... or someone takes off the wrong patient's dressing.. you chart on the wrong chart etc? But i guess they are all liabilities of the facility if something went wrong..

I understand the significance of your mistake(s), but perhaps it was not just the ONE error that ultimately resulted in termination but the other errors you have made as well (as stupid as they may be- I got written up because my manager noticed i left a roller clamp on.. she did not realize i left it on because it was inappropriate to give the med at the time when i went and assessed the patient, instead of taking the med down, i left it there).

From what I have read you must be doing some really deep reflection on the events. I hope you come out being an even better nurse from this :)

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.

:(

Well, a couple of things happened here. You failed to review the chart, the order, and did not identify the pt. as the CORRECT pt. the orders were writtten for; never mind the other identifiers you failed to ascertain.

Is it a fireable offfense? Yes.

Termination over the phone? Not appropriate, and if it had been done correctly, in a face-to-face meeting; you probably would have had all you need to know about this incident; and thus never had to post to this forum.

Specializes in Med surg, LTC, Administration.
Well, a couple of things happened here. You failed to review the chart, the order, and did not identify the pt. as the CORRECT pt. the orders were writtten for; never mind the other identifiers you failed to ascertain.

Is it a fireable offfense? Yes.

Termination over the phone? Not appropriate, and if it had been done correctly, in a face-to-face meeting; you probably would have had all you need to know about this incident; and thus never had to post to this forum.

This is true...however, being that this forum has young nurses reading and learning from it...I am glad, she did write. Everyone makes mistakes, but how you respond to them is what makes you a better or worse person for it. I remember being young and all the guilt I had, when I made a mistake. I thought I was the only one. I wish there had been a forum like this, so I could have moved on sooner, rather than beat myself up, unmercifully. Others need to see, that taking responsibility for your actions is a good thing. It takes tremendous integrity to admit, fix, apologize in a "culture" that is always trying to one up you, tear you down, etc...young nurses especially, need the assurance that the same "culture" is forgiving and respects honesty and accountability. When mistakes happen, it is not the end of the world, and more important when you learn from these mistakes you will grow into not only an awesome nurse, but an awesome person. Thanks for letting me piggy back! Peace!

I see noone here saying she is a bad nurse for making a mistake. We all make mistakes and hopefully we all learn from them. It is honorable that she wants to own up to it, but as a seasoned nurse of way too many years, one thing I have learned is that sometimes it is best to just acknowledge to yourself that you made the mistake, learn from it and move on quickly. When you try to make an issue or to publically acknowledge it sometimes you are cutting your own throat becasue then you force the facility to take it to another level because of wanting it hashed out. The manager may be doing you a favor by settiling it quietly and keeping more people out if it. If done formally and in a different manner there may be policies in place you don't know about that requiire more harsh punishments such as peer review or reporting to the BON that she is saving you from doing it this way.

Specializes in Med/Surg, Geriatrics.
WOW...for once I agree with SharonH on something...this is truely a first

Actually you agreed with me once before, it was last year. So.........yeah. :p

WOW...for once I agree with SharonH on something...this is truely a first

Actually you agreed with me once before, it was last year. So.........yeah. :p

either way, it sounds like a hallmark moment.:flwrhrts:

leslie;)

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

I was thinking the same thing..........Sharon's post was spot on, not to mention well-articulated. And she and I don't agree on anything either. :lol2:

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

I disagree with everyone re not meeting your DON.

You NEED to see her for your own peace of mind. You also need to type out a document, explaining what happened and acknowledge that yes, you didn't follow proper procedure and should have, what happened that day, were you busy, distracted. You need to see her face to face and talk it out, otherwise you will internalise it and stew over it.

You made a serious error. You learned from it - you have already said that.

Now you can do some reflection and think: what could I have done better? How can I avoid this error in the future? It's a good process to do reflection and write it all down cos then you get it clear in your own mind.

When I was a student a RN was removing staples and showing me what to do. In Aust we do NOT remove staples until the doctor has inspected the wound, and does a written order. Well this nurse removed a stitch/staple (can't remember which) from one end then the other & everything looked OK. Well she continued on, doing opposite ends, and the proximal end started dehiscing! It had looked OK before that, so we quickly stuck steri-strips over it, the doctor came and had a look - I don't know if she went back to OT, I can't remember.

S**t happens, especially when ur busy. You can't go around blaming yourself for everything the rest of your life.

Just make sure you follow all your checks that you need to do before doing meds, procedures, etc.

It is excellent also that you have taken responsibility for this mistake and are thinking through it - it shows a lot of maturity and, may I say, a lot of toughness!

I have a sneaking suspicion that you are a great nurse and will survive in the wilderness of nursing!

I have an interview tomorrow, should I mention this situation to the interviewer?

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