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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 blame you for being afraid to go back into nursing, you are suffering from a mild case of post-traumatic stress disorder. It sounds like you've taken steps to improve your medical knowledge -- great! Now take some steps to heal yourself emotionally. It's important to treat your emotional state before venturing into the nursing world again. Please read some books on resilience and positive psychology.
Resilient people are able to bounce back from negative events and succeed, and the two attributes they have in common are high self-esteem and a positive mental attitude. Your self-esteem has probably been damaged by your ordeal. Unless you address this, it will come out in job interviews and be interpreted negatively. Check out the book Resilience: Discovering A New Strength At Times of Stress by Frederic Flach, MD, or simply look for books with the word resilience, resiliency, etc. in the title.
You can learn about low self-esteem by reading Breaking the Chain of Low Self-Esteem
by Marilyn J. Sorensen, PhD, but if you're in a hurry skip right to the positive psychology books: Positivity and, if you get a chance, Learned Optimism.
Positive psychology uses proven cognitive behavioral techniques to help lift your mood and increase your self-image. Just by learning how important a positive attitude is to resilience and success will jump-start your recovery. One thing I learned is the "self-analysis" done while in a negative mood is not very accurate, and that such rumination actually harms our self-esteem, problem solving, and happiness.
Finally, check out some natural medications to help you overcome stress and rumination by reading Natural Medications For Psychiatric Disorders, written by a couple of Harvard psychiatrists. Here's a short list of suggestions to get you started:
- inositol -- tastes like sugar, considered a B vitamin by some, it is great for minimizing rumination, and is safe, even at very large doses
- valerian -- excellent for stress and trouble sleeping, very safe
Take care of yourself mentally and you will succeed! Good luck!
Yes, PTSD is not easy to deal with. And new nurses are very vulnerable.
So how does a nurse deal with getting a job knowing that her first employer is giving negative references? You must develop a positive story that explains your situation, and through your tone of voice and body language, you must imply that you are a resilient, positive, problem-solving person with good insight. This is the kind of person people want to hire! This is also the type of person that the Nursing Board is most likely to be lenient with.
Develop a good story to explain your situation. Admit you made a mistake, what you learned from it, and the steps you have taken to correct it. The story should also mention contributory factors, such as poor orientation and inexperience, but make sure to be factual and non-blaming. This is where restoring your self-esteem and positive attitude will help you, because without them you'll come off as too negative toward yourself and/or others.
A main trait of resilient people is that they see things, even "bad" things, in a positive way. For example, this experience has made you a much wiser nurse. It's given you an opportunity to increase your knowledge.
Another trait of resilient people is that they view mistakes as part of the learning process, and work to avoid making the same mistakes again. Explain that you've put an action plan in place that will keep you from making similar mistakes in the future.
Finally, resilient people are open to new paths. Being willing to consider school nursing is one example, but the job market may dictate your path for you. You must be flexible and positive! You must convince yourself that you can take on new challenges. The book The Secret of Success is Not a Secret by Darcy Andries is about the failures of successful people. A book like this will show you that successful people often endure many failures before they succeed. For example, Soichiro Honda was turned down by Toyota Motor Corporation during a job interview as engineer. He continued to be jobless until his neighbors starting buying his "home-made motor scooters."
It's unfortunate that nursing, and life, deal out situations that are unfair, but that's the way it is. Many nurses have had bad experiences starting out, but they have overcome them. For all you know, the person you are interviewing with is one of these people, and they will understand what you've gone through.
It sounds like you have already done much of the work you need. If you use this opportunity to improve your resilience, you will have learned something that will benefit you the rest of your life. Remember, the keys to resiliency are a positive attitude and healthy self-esteem! As you improve yourself in these areas, you will be able pass them along to your child. What a wonderful gift!
Supplyguy-
very inspirational post! I agree that the experience was very traumatizing and I have acknowledged that. In fact, I have filed a discrimination complaint with the EEO regarding the treatment I was subjected to in the workplace and I had an interview the other day about my experience. After the interview, I felt terrible! It was as if I relived that dark time in my life briefly. And I realized that I am a much stronger- more resilient if you will- person because of it. Furthermore, I have come to believe that I learned an extraordinary amount about hospital politics, the importance of policy/procedure, the danger of medical errors and of course, the importance of being on your manager's good side.
As other nurses have suggested- "don't let this experience cause you to waste your years of education and hard work"! I know that the market is not great right now, but you are correct in advising that I accept "where it takes me" and be open to the experience.
7 months ago, I thought maybe I was unfit to be a nurse- too unorganized and just plain incapable. But now I think my situation was a result of a combination of factors, most of which can be changed. I was not well trained, I was pregnant for the first time, my manager was a nut who had a personal problem with me, it was my first nursing job, and I needed further education. I think that if I can start over in a new job, I can manage to be better at following policies and if there is none, not proceeding without seeking one out. Also, I now know that if I need more time or if I am overwhelmed, I should not try to "get it all done" at the risk of making errors. I also know that I need to be trained thoroughly and should not be on my own until I feel fully comfortable because my license is at risk with every mistake that I make.
As I said, I have been continuing my education when I have time and I feel like that is another step in the right direction. One of the most important things that I learned is that if my manager is discriminating against me, I need to go to HER manager immediately. I should not subject myself to the abuse in hopes that I can prove myself to her and get her off my back.
And yes, I am staying positive about the whole thing, even though it can be overwhelming sometimes to even think about.
Just one final thing....I had a reference checking company call the HR dept at the hospital and they told them that I AM eligible for rehire. My NM had told the company that I was NOT eligible for rehire!! I think that speaks for itself...
Thanks for your replies!
C & C,
You have convinced me! It sounds like you have really learned from your experience, and your insight is excellent. You have taken this "bad" experience in a mature and positive way -- I'm impressed!
Your challenge is to summarize your story, deliver it with conviction, and keep positive about yourself and your abilities in front of a skeptical manager.
One thing that might help: Try understanding your former tormentor / manager. My guess is that she has low self-esteem which causes her to pick out victims to abuse in an effort to make herself feel better. The stress she experiences on the job is temporarily relieved by bullying. Once you grasp that, your bitterness towards her will begin to diminish. This will come across in the interview, and you've just scored another point!
This doesn't mean you need to forgive her. You job is to keep yourself from being victimized by someone like her in the future. Abusers look for vulnerable, "nice" people they can victimize -- if they sense they can push your buttons, they will. By being calm and confident, you will be a less attractive victim. You have probably been a victim in the past, even if you don't realize it now. A positive, problem solving attitude will help you immensely. The trick is staying calm and in problem-solving mode when under attack.
There are many books about how to deal with an emotional bully by changing yourself. Two excellent ones are Who's Pulling Your Strings and Emotional Blackmail. Other good ones include: Dealing With Difficult People; Emotional Vampires; and In Sheep's Clothing.
Many of the books I've suggested are available at the library. You don't need to read them cover-to-cover. Just skim them and pick out a few pearls of wisdom. Then reinforce the pearls by making post-it notes and sticking them where you'll read them. I have a post-it note program on my computer. I've programmed different notes to pop up on different days.
You can also make a tape of the pearls with some soothing music in the background. Play it when in the car, or anytime you want to relax. When you notice an improvement in yourself, congratulate yourself. It takes some time, but gradually you'll incorporate more and more of your learnings.
Above all, stay positive! Negative feelings will undermine your ability to problem solve and persevere. Negative self-talk is the main thing that prevents us from making positive changes in our lives. You don't have to be perfect to be a good nurse. YOU CAN DO IT!
Thank you for your book recommendations! I plan to check them out. You are right that my NM had emotional issues. The hostility vibe that she gave off was almost unbearable at times. I discovered through the course of my employment that her daughter was killed in a car accident the previous year and that her marriage was very unhappy. Of course, that doesn't excuse her behavior, but perhaps it explains some of it.
I also think you're right that she saw me coming- victim. This has not come up until now, but I am a single parent and was single throughout my pregnancy. I know that my manager had a moral problem with that because she divulged her religious beliefs to me at my interview. As I type this, I realize that I was really setting myself up for failure by accepting the position with her in the first place. But I would never have anticipated that it would turn out this badly! I now know to avoid any position or person that flies their red flags so proudly.
Yes, I think I am "too nice" sometimes. I feel like I am having my boundaries tested. She must have sensed that.
Anyways, thanks again for your insight! It has been really helpful and fortunately, having a little one really has changed my attitude into a more positive one anyways, so I do hope that I give off that vibe at future interviews.
Also, the NM had a lot of friends that she made throughout the hospital before her daughter had died and they could not believe that she had become a tyrant. The NM was not just harassing me. She also harassed older employees, some nursing assistants, and anyone who was involved in the union. Every month someone quit or transferred. She did have well known targets that were always forced off the unit. I was the most notorious because she made her dislike for me well-known. In fact, I once over heard her gossiping about me to someone on the phone! I was very upset that day. It was all I could do to not walk out.
Also, the NM had a lot of friends that she made throughout the hospital before her daughter had died and they could not believe that she had become a tyrant. The NM was not just harassing me. She also harassed older employees, some nursing assistants, and anyone who was involved in the union. Every month someone quit or transferred. She did have well known targets that were always forced off the unit. I was the most notorious because she made her dislike for me well-known. In fact, I once over heard her gossiping about me to someone on the phone! I was very upset that day. It was all I could do to not walk out.
My last job my NM was NM sister, so I can feel your pain. Fortunately, I was an experience nurse and new I needed to get out. Now I have a great position and have an equal position in the same system. Something good will come you way, please kiss your baby for me and Happy Mother's Day.
When applying for other jobs, still list them as a place of employment. When it comes time to reference check, can you tell the prospective employer that your last supervisor no longer works there? Then they can contact HR and just verify employment dates etc. They could get character references from other people or other past employers.
Dear Crimson and Clover,
I too was challenged about my professional boundaries. A pt got very attached to me. Unfortunately, the school found out and I got into a huge mess.
I too have reflected and learned from my mistakes. It didn't take long to learn that I am not present at my workplace to make friends but work professionally. I am there to do what I have to do and go home when the shift ends.
Ginger's Mom, MSN, RN
3,181 Posts
I was trying to keep an open mind, perhaps you were making up how bad the manager was, but she is completely stupid, all she had to say, it is not our policy to give out references period. Now I know you were completely truthful.
Mention it on your resume, don't list as a reference, say you had professional differences ( it happens). Enjoy your baby and search carefully for your next job.