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.

I don't believe the malpractice would have covered you since a patient is not suing you.

Are you resigning, you were unclear to me in your response. I would not leave this off your resume. May people do not have a good fit with their first position, this in not uncommon. Is there anyone a new employer could call, a preceptor, a supervisor, or a charge nurse would could verfiy your employment.

I don't think if you resign they will report you to the board,if you go to the hearing and find you at fault you, adminstration may request the board be notified.

Good luck with new baby and a new position, perhaps a per diem position while pregnant would be a win win situation.

I did resign, effective tomorrow, actually. I do have preceptors that would be references for me. During my orientation, I was actually shuffled around quite a bit, so I can count pretty much every nurse on my floor as a preceptor (including the LPNs). I am an RN.

Thanks for the encouragement. I am two weeks from my due date at this time, so I plan to worry about looking for other employment following a lengthy "maternity leave".

I spoke to an attorney, who was actually representing the hospital that I work for and he told me that they often send these reports as a formality. I also looked at my BON website and they state that if a nurse resigns in the face of a peer board review hearing, that is cause to be reported. Plus since my manager is alleging that I am unsafe, I think she is a mandated reporter. However, I believe that she should have reported any medication errors in a timely manner and since it has been months since I made any errors (with the exception of one), I don't think there is anything to be done about my performance while I was orienting.

Plus, the attorney at the hospital told me that what they would send to the BON is the memorandum my NM put together. The first two pages of the memorandum are dedicated to issues surrounding my pregnancy, like I requested to leave early due to a prenatal appointment and I was concerned about contact isolation. To me, that is not something that I should be disciplined for. Or even something to be taken seriously by the BON. If I was reviewing the memorandum (which does not include incident reports, even), I would probably dismiss it because it makes no sense.

I swear if I had more energy, I would fight this thing. But as it stands, this facility is sub-par and the education I received is indicative of that.

I think the would have been helpful so that I could get free legal counsel from my insurer.

The next position I take will have to provide extensive training appropriate to the novice nurse, as I am never putting my reputation in jeopardy again.

I mean, I should have been given more training the moment management noticed that I was not aware of many of the policies and procedures!:no:

Good luck with your new arrival. If you are reported to the BON ( I suspect they won't since you resigned) you need to fight it. But by that time you will have the strength to fight it.

Chalk this up to a bad first job, your next will be better.

Well, I just got a letter from my former employer summarizing their reasons for reporting me to the BON. They say that I can respond to the accusations within 14 days or they will decide independently whether or not to report me. I am afraid to make any further contact with them and fear that I may need legal advice at this point. I just got my license in February of this year! Anyone have any thoughts/advice?

And on top of it all, my baby is due any day now!

Well, I just got a letter from my former employer summarizing their reasons for reporting me to the BON. They say that I can respond to the accusations within 14 days or they will decide independently whether or not to report me. I am afraid to make any further contact with them and fear that I may need legal advice at this point. I just got my license in February of this year! Anyone have any thoughts/advice?

And on top of it all, my baby is due any day now!

Yes. You get a lawyer NOW and let him take care of this.

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."

Jolie, I respect your advice above, and hope you can provide me with some insight on my situation. My manager has been building a case on me, and fortunately I never made any serious medical errors. But I knew it was time to go, so I emailed my resignation in hopes of preserving my "eligible for re-hire" status. My manager responded with the following: "I believe that you will find the right fit for you. You are intelligent, compassionate, and want to do the "right" thing. Please stay positive and the right match will come. Let me know if I can be of help."

Should I respond with a request for a reference letter? How should it be worded? Is the manager serious about wanting to help? What if I request a letter and she blows me off? I'm not good in dealing with this type of thing, so your advice is much appreciated. Thank you!

Specializes in Operating Room Nursing.

Hmmmm I agree that your nurse manager has acted quite unprofessionally by asking you about the pregnancy etc and sabotage.

But I'm actually quite concerned about the number of med errors you have made in just six months of nursing. From reading your post it sounds like you made quite a few in a relatively short period of time. Now I don't want to appear overly harsh because I'm not perfect and nobody is but IMHO the best thing you can do for yourself is to seek further education about administering meds to improve upon your knowledge deficit. Find out if there are any courses in your area on medications, look through pharmacology books, there are some excellent pocket nurses guide to drugs as well.

And if your asked at this meeting about why these errors occured, don't just blame everyone and say 'i had no education, was short staffed, not feeling well that day' etc, because that will go against you, they'll just see you as unwilling to take responsibility for your actions and you will lose all credibility. As an RN you can't just shift the blame like that, you have to take full responsibility for everything you do.

I hope it all goes well for you, hope your baby is well.

Specializes in ICU.

The email she sent does sound a little weird, considering all the information you gave us. What happened? Did you ever email her back and ask for a reference?

You're probably busy taking care of your baby now, how is your baby? Please update us... congratulations!

My attorney also advised that I seek continuing education in order to show that I am learning from my mistakes. So I have been doing courses online about medication safety. I do believe that I was poorly trained in addition to a knowledge deficit. I had my baby November 10 and he is perfect. It stinks to have to think about these things right now but my facility has submitted their complaint to the board and they are currently investigating.

Also, my attorney ended up agreeing with me wholeheartedly on the pregnancy discrimination and so I have filed a formal complaint on that.

So, that's where things stand right now. Hopefully I won't hear from the board until I am feeling comfortable with the baby and ready to deal with them!

COngrats on a healthy son!

Keep us posted on the rest. Glad you got a lawyer.

You've been a "difficult" employee almost from day one.

In 6 months you've made 3 med errors, 2 errors of basic procedure and another that you didn't identify as being a med or procedural error.

Yes, your NM made some very distasteful comments (that I assume were unwitnessed) but that is not going to bear any weight against her black and white documentation of poor performance.

Also, don't believe your coworkers that they gave positive feedback about you to your NM, the reality is no one will tell the truth if they have given negative feedback because they don't want to deal with the drama and having to work with someone in that situation.

And I realize you got a good 3 month review but consider it was given after you accused her of making a hostile work environment. That review effectively removed any claim you have that the environment was hostile or she was out to get you and is something many a smart manager will do.

I'll be honest, If you worked for my employer...they would view you as a safety concern and the union would support their decision to terminate you.

Not to continue to be "difficult", but what about the fact that my NM DID create a hostile environment for me from day one (as she knew of my pregnancy)? Further, why was I trained differently than other newly hired staff? True, I made errors and was "difficult" to accomodate due to pregnancy related complications. Also, I agree that a new grad who is poorly trained is absolutely a safety risk. I am sure that I will never be in that situation again, partly because I am no longer pregnant, but also because if there ever was another time that I felt I was being discriminated against, I would get the hell out of the facility before they have the chance to go after me personally because I refused to give up and just quit.

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