Threatened to be Fired for "patient safety" issues.

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Hi, I am a new grad looking for some advice or opinions on this issue I am having. I have been working for 6 months at a hospital and have been having some problems there. At my interview, my NM for some reason told me that it annoys her when people call in sick to take care of their children and questioned me about my race because I have an ethnic last name. I thought she was strange, but decided to accept her job offer anyways a couple weeks later. Anyhow, I discovered I was pregnant with my first child shortly thereafter. I felt it my duty to inform my upcoming NM about the situation and she was very apprehensive, asking me how much time I would need off for leave and if I still planned to work full time day/nights. I told her not to worry, my job would come first.

Once I started orientation, my doctor placed me on a 25 pound weight lifting restriction due to the pregnancy. My NM told me that if I brought in that note, I would not be able to work at all because I no longer fit the job description of being able to lift a minimum of 50 pounds. I consulted with my union and then opted to not bring in the note.

Shortly thereafter, I was rear-ended by another motorist on my way to work and placed on a 5 pound weight lifting restriction for 2 weeks. My NM was less than pleased. She placed me on leave without pay for that time. She said she probably could have accomodated me, but was not required to, since it wasn't an on-the-job injury.

Needless to say, I was not on my NM's good side. I was also exhausted from my pregnancy and not always feeling well. However, I dutifully came to work everyday.

After working with a preceptor for 2 weeks, I was placed on my own with the most difficult patient on the floor. I made a medication error at this time. I did not know the procedure for removing fentanyl patches and removed one early. After that, I was placed back with a preceptor for an additional 2 months or so. I made one more medication error (gave wrong dosage of tylenol) and then made a medication error in conjunction with another nurse. It was another nurse's patient and she had set the IV pump to end early. It was the night shift and I didn't see that there was still about 75 ml of medication left in the bag as it was also covered with foil to protect it from light. This was over the course of 3 months or so.

During this 3 months of orientation, my NM suggested that I look for jobs elsewhere and that the other nurses did not like me. She told me there was no positive feedback about my performance. I knew that there had been, however, because I had feedback from other nurses who told me that they had gone to my NM with positive feedback. At the time, I told my NM that I was not going to quit and that I felt she was creating a hostile work environment for me. She let up and gave me a positive review at my 3 month review, saying that I was "right where I needed to be".

Things were going well for a couple months. There were a couple times that I didn't know the policy for my floor regarding certain situations. For example, I didn't know that after a patient falls, we were to institute neuro checks every 15 minutes for so long and then every 2 hours for so long. I also didn't know that insulin would have to be double checked by another nurse to avoid giving the wrong amount.

But once I made one mistake, especially a procedural mistake, I never made it again. I always learned and never did something the wrong way twice. I put a lot of effort into my nursing practice. Later on, I ended up disconnecting a patient from an IV for a half hour to take him to the bathroom, then found out I wasn't allowed to do that.

About a month ago, my NM accused me of making some kind of boundary violation with a patient because I had visited him during my shift to see how he was doing while he was on another unit temporarily. The patient confessed that he had a crush on me and I told the charge nurse, who rather than advising me to no longer accept him as my patient, told my NM that she felt that I was encouraging him. Turns out she advised me incorrectly and I should have refused to work with him again after that. I went to the union about this and they totally reamed my NM out. About a month later, I gave Vicodin to a patient too soon after he'd had his last dose and my NM put together a packet of allegations and threatened to fire me.

I was told by other staff recently that my NM had been collecting this information from day one, asking people to write down mistakes that I made. She kept a personal file on me and then denied me access to it. A couple things in the packet were never brought up to me. No positive information about me was included in the packet.

So, now I am up for a hospital board hearing to determine my future with this hospital. My feeling is that I've made mistakes, but none of them has been serious. The last one was probably my most serious mistake because rather than giving this patient another dose of vicodin, I should have called the doc to ask permission. That one is probably inexcusable, but the others I feel were genuinely education-related.

My gut feeling is that my NM has not liked me from day one and the fact that I have made mistakes has been great for her because she's been collecting evidence. She doesn't like the fact that I started pregnant, that I've gone to the union several times, and probably just plain doesn't like my personality.

So my question is, have I really been that unsafe that I should be fired? How many and what sorts of mistakes do new nurses generally make? I really want to learn from this experience and have been doubting my nursing practice. Thanks.

Any tips or opinions on whether or not I should go to that board hearing? I am concerned that the hospital board may submit something to the BON, even though the mistakes were generally minor (in my opinion). Not that this makes it okay- but no one was injured and only one was made post-orientation. Thanks again!

I'm sorry your going through this. Work is stressful enough without having to deal with a NM like that. Like other posters have said, I would RUN from this place. It does sound as though your NM has had it in for you from day one, when you told her you were pregnant. I feel that things will only get worse for you at that place, unless the culprit (NM) leaves. Find a place with better managment support. I would hate the feeling of someone breathing down my neck at work, just waiting for me to mess up so they can hold that against me. That would be enough to make a person make even more mistakes. I hope the best for you and hope you get outta there sooooon!!! :heartbeat

I would fight for my job. Just so that in the future you won't have a do not rehire in your file. I wouldn't worry about them turning you in for drug errors to the BON. I think they save that for nurses that were diverting the drugs to themselves. But I could be wrong. Once the meeting is over and if you have been reinstated I wouuld either put in a transfer to another unit or turn in my 2 weeks notice. Like you say you would be due around that time and you can use that time to spend with your new baby.

Specializes in Geriatrics, Med-Surg..

This is so much to go through when you are pregnant and esp. with your first child. I hope that you will take some time to relax. I'll bet that somehow things wil work out for you even if it means leaving that place. I think the fact that you admit you made errors (and we all do) says a lot about your willingness to learn.

I must agree with the other posters, your NM sounds like a mean person and it sure does not sound like you had much of an orientation.

Best wishes to you and your baby.

I think it depends on how easy it is to find a job in your area. If you can easily walk into another job, I'd just cut my losses and go as this place isn't worth the stress and strain it's putting on you. You do not appear to be an unsafe nurse. I just think you've got a real creep for a boss. As others have said, put yourself FIRST, not a job. And now you've learned that when you have that niggling little feeling in the back of your mind that maybe the situation isn't a good one, listen to it and run. I, too, have learned that the hard way, but now I always listen to that little voice that tells me a situation may not be a good one.

crimson, NO WAY will you be disciplined by the BON for this stuff. Don't worry about it at all.

Crimson and Clover,

I'm so sorry you're going through all of this. you especially don't need this bs while you're pregnant. I would go to the hearing, and I would be sure you have aunion rep with you, at the very least. If you can afford it, I would bring a lawyer.

I am aware of two situation in which an employee brought a lwayer with them to an employer hearing, and both times, the employer backed right down.

I agree with the other posters here that your mgr is basically a nut.

From your posts, you appear to be a very intelligent nurse with a lot of insight.

I know you want to fight for your job. Maybe you can transfer to another unit?

Whatever the outcome, we're rooting for you.

And congrats on your pregnancy!

You are responsible for knowing the professional standards such as neuro checks every 15 minutes, there should be a policy manual on the floor that you should be referencing.

To prove the racial and pregnancy issues your manager will have to agree that she said them ( unless there is a witness).

If this is your first job and you get an employment attorney you may be black balled from other positions. Who are you going to get for a reference?

The nurse manager sounds like the nurse manager from hell. That being said, when I have been in this situation I have done everything by the book. If you felt your assignment was overwhelming you needed to document it immediately.

The board hearing is not going to overturn the nurse manager unless she has a history of being abusive and unfair ( documented in Human Resources). Every time you made a mistake she has been in contact with HR, have you been documenting your side with your union? Did you bring in your union rep when she spoke to you, that is your right.

Sounds like you are in a no win situation, you are not protected by the family leave act since you have not been employed long enough. Take care of your baby. I would not have disclosed this to your NM so early, next time you need to occupational health, and they will inform her if you have restrictions without disclosing the reason.

Sorry to ramble on, you seem like you want to do the right thing, and got screwed, time to move on. Personally I would have either left or transfered before this situation got so far. You need to move professionally.

If the Board overturns the NM, you need to be perfect and clear your nursing record and move on. Good Luck and best wishes,

This isn't going to be a popular opinion, but I'm posting it anyway.

You actually were not legally or morally obligated to tell your nurse manager that you were pregnant. The time to tell would have been if they started asking questions or you were asked to touch medications or deal with patients ie. MRSA that would have put you physically at risk.

Unless you had a specific problem with your pregnancy, I don't understand the purpose of the 25 lb weight restriction from the start. That is why she asked for a doctor's note. Many nurses work through their pregnancies up to the due date with no problem...so if you didn't mention a problem other than the fact you were pregnant, that is why she wanted a note from your doctor to quantify the reason for the restriction.

When you got into the accident and this same doctor put you on a 5lb weight limit....you started treading into water whether or not they could still reasonably accommodate you at all.

You would have to have assistance anytime you helped a patient with ambulation, you would put your patients at risk every time you entered a room because if something happened, you couldn't move them without assistance in order not to violate the weight restriction.

Once you informed your employer of the weight restriction, if they choose to continue your employment, they have to take responsibility.

So with all of that....in essence, you really were not able to work at all.

Legal or not, anytime you have a condition and/or illness that requires extensive accommodation as a brand new employee, you are always putting your head on the chopping block.

Whether it's right or not.

Union, will only get you so far, especially when you keep going to them over and over again.

If a company wants to find a legal reason to fire you, they will eventually find it.

Specializes in Geriatrics, Med-Surg..

Some of these excellent responses got me thinking and I was wondering if you have a professional association that you belong to. Often these organizations have a practice consultant that can give you advice on issues like this before it gets really bad. They may even offer malpractice coverage for certain situations. Just a thought.

Specializes in Maternal - Child Health.

Hopefull has raised some valid points about the OP's situation.

It seems to me that this arose from a combination of questionable management practices coupled with the actions of a well-intended, but naive new nurse who is learning from her experiences. IMO, it would be in the best interests of both the OP and her employer to seek work elsewhere with a good reference in hand.

I wish you the best of health and much joy with your baby!

Hopefull2009, my NM didn't ask for a note restricting the weight lifting at the start. I told her I had one and once she told me that if I brought it in, I would have to look for other positions, I chose not to bring it in. A 25 pound weight lifting restriction seems to be the standard nowadays as far as pregnancy goes. As far as being rear-ended by another motorist and put on a 2 week restriction, well, there wasn't much I could do about that and accepted leave without pay until I was cleared of miscarriage precautions. I suppose I understand that as a new employee, having medical issues right away doesn't win me any friends, but at that same time- doesn't it say something about the management that holds it against me for the rest of employment? After I was cleared of the 2 week restriction, I was back on the floor, working very hard not to make mistakes, WITHOUT restrictions. So it was a total of 2 weeks that I couldn't lift more than 5 pounds, at which time I took leave without pay. I was not accomodated.

Alexk49- I am NOT a seasoned nurse and DID have a lot of learning to do. I knew that making mistakes was not an option for me because I was already on manager's bad side with the pregnancy, but unfortunately, I managed to make mistakes anyways (mostly procedural). :banghead:

But I DID have a positive 3 month review- after having made errors on orientation- so, what gives? I DID document my side to every story with the NM and once I caught on to the fact that I should have witnesses to my interactions with my NM, I started invoking my Weingarten rights. I guess I've never been in a work situation that was so complicated and where you really had to cover your butt constantly and be on the offensive. My NM HAS had a history of being unfair, hating the union, and playing favorites with employees. There are many documented grievances on her behavior- so I think she will get hers one of these days. Probably not in my time there, though.

Oh, by the way, our floor was half MRSA positive and I did have to ask occupational health about whether or not I should be working with these people and what my restrictions were. They wouldn't say anything and told me to go to my doc, which I did, and ended up with that 25 pound restriction and to avoid MRSA. Because I wanted to continue working, I never brought in the note and my NM and I pretended I was not on a restriction.

And again, as much as I would like to have been perfect, I think that is something to strive for, but I realize now, impossible. Even the best nurses make mistakes sometimes and I feel I have been judged much more for my mistakes than on the positives of my nursing practice. Granted, I mainly mentioned my mistakes here and so how is anyone supposed to know that my charting is impeccable, my bedside manner exceptional, and my ability to learn above average? How would anyone know that no matter how tired and stressed I was I kept going to that hostile environment day in and day out and never let on to my patients that anything was amiss?

And of course, as I say, I realize now that EVERYTHING has a procedure.

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