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.

crimson, what gives is that from the beginning of your employment you had limitations on what you could do. You were largely a liability if you were being trained AND pregnant and therefore in need of special considerations regarding patient assignments.

I think your NM stinks, but you have to be a little more realistic about why she might have been mad. Again, she's a lousy manager, but you were a PITA employee from the beginning.

Cut your losses, make sure you get a reference, and hang out until the baby's a few months old. And say you left because YOU felt that your limitations were a hardship to your unit. You'll win friends on the interview if you take that attitude.

Well, as I said, my only documented limitation while I was there was during that 2 weeks. I DO understand why she would have it out for me since I started pregnant and then got into that MVA. It was a bad situation being my first nursing job and my first pregnancy because I really did not know what I could and couldn't do. Anyways, I can see why she wanted me gone from the start, and then I went to the union for advice a few times, made a few mistakes, and bam- she's trying to fire me. It is not a surprise to me at all. I knew this was coming, but I thought if I work hard to learn from mistakes, take criticism well, and be responsible- maybe I had a chance of overcoming that first few weeks.

Oh yes, and in the future, I would never again disclose a pregnancy until much later on! This job has been a real learning experience in what NOT to do.

Thanks everyone for your thoughtful responses. I know it is a convoluted situation that has many layers and is not black and white. I appreciate all the responses I've gotten and it has been really helpful to me to hash it out with other nurses who know what I'm talking about. This is a great forum!

Well, as I said, my only documented limitation while I was there was during that 2 weeks. I DO understand why she would have it out for me since I started pregnant and then got into that MVA. It was a bad situation being my first nursing job and my first pregnancy because I really did not know what I could and couldn't do. Anyways, I can see why she wanted me gone from the start, and then I went to the union for advice a few times, made a few mistakes, and bam- she's trying to fire me. It is not a surprise to me at all. I knew this was coming, but I thought if I work hard to learn from mistakes, take criticism well, and be responsible- maybe I had a chance of overcoming that first few weeks.

Oh yes, and in the future, I would never again disclose a pregnancy until much later on! This job has been a real learning experience in what NOT to do.

The other piece of advice that I'll give you, is never go to the union unless your license or your job is at risk. It's all about picking your battles.

Once you go to the union (or human resources, if your hospital doesn't have a union), your head is on the chopping block from that day on with management.

Yes, it's not right. No, it's not fair. It's also not totally legal, b/c they are not supposed to retaliate against you if you make a complaint...but that is where they will watch you like a hawk and just wait for you to mess up, so they can start documenting like crazy and legally get rid of you.

I wasn't trying to defend the NM...just give you a heads up on what you can do differently. Maternity leaves are expensive, and any employee that has to be worked around, regardless of the reason, places a hardship on the rest of the staff.

I personally have never heard of a weight restriction during pregnancy unless it's the last trimester, post-partum, or if you are at a high risk for miscarriage. When you think about the practicality of it when working with patients, that's hard to maintain.

What OB's warn about is to not try anything NEW that may cause you to over-exert yourself. If you lifted weights at the gym before you were pregnant, then you should be able to after pregnancy. So if you were lifting patients before you were pregnant, no reason you can't while pregnant.

With the MRSA...I am with you on that one...I would probably walk out of a job before I would take care of a MRSA patient if I was pregnant...absolutely no reason why you should have to do that. However, you would volunteer, let's say, to take an extra patient or two to make up for the nurse that has to take that patient...you see what I mean?

I'm still a student myself, but our instructors have also taught us alot about the political side of nursing in a hospital, b/c that can make or break your experience in a new position.

Move on, honey. If you can transfer do that, but otherwise, cut your losses and find a new gig. She will NOT blackball you, you will NOT be disciplined by the BON, and there's a good sot you can get out of here - or to another unit - with a good reference.

Your preceptorship was deficient, her management skills are non-existent, and you're pregnant. A very bad mic.

:)

Yeah, I don't really expect to be keeping this job, and what IS important to me is learning from this experience and taking that with me in the future. Hopefull2009, you are absolutely right that my union involvement may have been excessive and setting me up for failure. True, it's not fair, but look what happened.

I guess I am hesitant though to use this hospital as a reference. I DID learn a lot there, but at the same time, they are alleging that I practice unsafely and don't follow procedures. Plus, I've got a board hearing that I can choose to not attend, but honestly, I really want my side of the story out there and don't want to concede to their allegations, although I have a feeling that they WILL side with the NM and that it's hopeless.

I don't see how hiring an attorney (I have a consultation only right now) for advice on this matter could affect future jobs.

Specializes in Maternal - Child Health.
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.

This is the part of your post that concerns me most, because it appears that you voluntarily put yourself and your baby at risk by disregarding your doctor's advice.

"my NM and I pretended I was not on a restriction."

Your manager did not pretend anything. Without formal notification, she had no way to verify nor any reason to follow your doctor's instructions. You chose to deep six the doctor's note because you believed it would have impacted your work situation, which was probably correct. But it is not fair to place responsibility for this onto a manager from whom you deliberately chose to hide the note.

As I said earlier, there is plenty of responsibility on both sides for your unacceptable work situation. Managers do boneheaded things sometimes. Staff nurses make mistakes. I hope that you can all learn from this mess and become better for it. The first step in that process is to acknowledge one's responsibility, and to realize that it is never worthwhile to put oneself or an unborn baby at risk in the process.

The only reason I brought up the weight lifting restriction was to illustrate the entire picture. Jolie, I guess I don't know what you mean about putting responsibility for the 25 lb weight lifting restriction on my NM. I believe that she felt like having me around was a hassel and that has contributed to my upcoming board hearing. I never brought in the note because I considered it and decided that if thousands of other pregnant nurses could work in the hospital, why couldn't I? I did get a second opinion on whether that weight lifting restriction was necessary and deduced that maybe it was more a matter of opinion rather than fact- as I got mixed responses from practitioners. I guess my point is that she DIDN'T have to accomodate me, but I still believe the damage to my reputation was done. I was labeled as a "problem employee" at the start because of pregnancy-related issues.

This forum has been very helpful for my to muddle through what has happened and to learn from my errors, both in terms of nursing and in terms of the politics of nursing and starting your first job. I suppose I drift back to the original question that brought me to the forum and that was my concern that there was merit to the allegations. I can totally accept that I should have kept my mouth shut about the pregnancy and picked my battles when I went to the union. What I would have had difficulty accepting is that I am just not cut out for nursing because I am incapable of performing my duties safely, which seems to be what my NM is alleging.

As far as the job goes- I couldn't be happier to never see my NM again and I really don't mind too much starting over somewhere else. But I feel like I couldn't go through an ordeal similar to this one again and wonder if I shouldn't just give it up.

It sounds like from the posts I have received that although mistakes HAVE been made, I am not necessarily unsafe, rather the situation is complicated by poor management, inadequate training, and starting my job with medical issues. Thanks for all of your responses

Specializes in Maternal - Child Health.

I am impressed by your final post. You clearly are trying to learn from a bad situation, and not just make excuses for your mistakes or blame your manager. I am certain that you will learn and grow from this experience.

Given my optimism for your future in nursing, I'd like to offer a little advice based on years of experience as both the staff nurse and the manger. If you come to an agreement with your employer to amicably part company, I would suggest immediately requesting a reference letter (written on hospital letterhead and co-signed by your manager and HR) to take with you. That way, you can bring the original to future interviews, allow the interviewer to copy it for your file, and have no reason to think that your former employer will try to screw you over by labeling you "ineligible for re-hire."

At the time you apply for future positions, you will be a new mother. Be aware that it is not proper or legal for an interviewer to ask about your marital status or inquire about children. If a manager tries to pursue this line of questioning, simply smile your best smile and state, "I'm sure you are aware that this is not an appropriate question. I would like to discuss my professional qualifications, not my personal life, since that has no bearing on my ability to provide excellent patient care." This is a very difficult stance for an inexperienced candidate to take. Practice it. Reheorifice the line! Don't allow the interviewer to take you into personal matters, and don't go there yourself. If you mention your family obligations, you make the topic fair game, when it otherwise would not be.

Practice your answer to the questions about your gap in employment without mentioning your new baby. It is OK to say that you needed time off to focus on a personal issue (that is now resolved) but don't state specifically what that issue is. Another way interviewers have to find out personal information is to ask about your hours of availability. They may ask if you are limited due to childcare needs. Simply state the hours that you are and are not available and don't offer any information as to why you can't work 24/7.

Best of luck to you. Enjoy your baby!

Yeah, I don't really expect to be keeping this job, and what IS important to me is learning from this experience and taking that with me in the future. Hopefull2009, you are absolutely right that my union involvement may have been excessive and setting me up for failure. True, it's not fair, but look what happened.

I guess I am hesitant though to use this hospital as a reference. I DID learn a lot there, but at the same time, they are alleging that I practice unsafely and don't follow procedures. Plus, I've got a board hearing that I can choose to not attend, but honestly, I really want my side of the story out there and don't want to concede to their allegations, although I have a feeling that they WILL side with the NM and that it's hopeless.

I don't see how hiring an attorney (I have a consultation only right now) for advice on this matter could affect future jobs.

You are very welcome.

Just remember that companies only have unions because once they have formed, it's against the law to disband them and not all unions are created equal.

A great example is the auto-workers union...yeah, some of them get $35 an hour for pulling a lever all day, but they have also priced themselves out of a job...b/c cars have went up much higher than salaries and now you are lucky to drive one that will outlast the payments. That is why foreign cars do so well here...b/c they don't have to pay for that stuff overseas.

Also, be sure to carry individual on yourself. The hosptal only covers you if you follow procedure...which means if you make a God-honest mistake or they unjustly accuse you of something...it's up to you to foot the bill for it.

It's a myth that a nurse is more likely to get sued if she has it...first, there is no national database to search for that information, second, you don't have to answer a single question an attorney asks you...including if you have insurance or not, and third, if nurses were more likely to get sued, insurance would cost a heck of alot more than just a couple hundred a year...ESPECIALLY for new grads.

Yes, I realize would have been very helpful in this situation by making available legal advice. At this time, I decided going to a peer review board hearing and potentially being terminated was a bigger risk than I was willing to take. I did consult with an attorney who basically suggested that I quit because a resignation would be easier to explain than a termination. Obviously, though, I'd rather leave this off my resume.

However, I believe that the facility is required to report me to my BON as I resigned amid potential charges. But as I and others have said, I have not stolen medication, come to work high/drunk, abused anyone or done anything like that. So hopefully no action will be taken against my license. I've only been licensed for 7 months!

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