Threatened to be Fired for "patient safety" issues.

Published

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.

Specializes in IMCU.
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 hope all this has turned out well for you. You were definately in a toxic environment. Yes you made some mistakes but you should have been counseled and re-educated since you obviously did not know all the proceedures as you were not given a proper orientation. I don't know how you could have not been told about the insulin verification policy but i am sure it happens and the vicodin administration error seemed obvious, but mistakes are made.

You should have reported yourself, done an incident report and maybe got a write up but certainly would not have gotten in big trouble at our facility. I have known of people that got in trouble for this or similiar at our place but had history of being careless and were not new and then some people that had made major judgement errors and/or med errors who didn't even get their hands slapped. Politics are a big deal in nursing. I hate it, but that is the way it is.

I am glad to hear you are taking the continuing ed classes. Don't give up without a fight. You absolutely were discriminated against. Keep your lawyers advice, jump through all the hoops required and be one new nurse who fights back. Have fun with your little man!

Mahage

I did not read all of the responses but hopefully someone has mentioned that the initial interview questions and comments were a huge red flag. I so wish nursing schools would train people on how to deal with this in an interview situation. The fact is, even if one gets past an interviewer like that you do not want to take that job unless you are DESPERATE.

I really wish you luck.

I did not read all of the responses but hopefully someone has mentioned that the initial interview questions and comments were a huge red flag. I so wish nursing schools would train people on how to deal with this in an interview situation. The fact is, even if one gets past an interviewer like that you do not want to take that job unless you are DESPERATE.

I really wish you luck.

When I first started in nursing in the 1980s, questions and comments such as the ones this NM made were not prohibited. "Do you have children" and "Do you plan to have children" was asked of me more times than I can count. If the NM had any age on her, she may not have known that it is now illegal to make inferences to an applicant's race or intent to have children. But that's giving the NM the benefit of the doubt :wink2:

That said, I DO believe the NM knew what she was saying is prejudicial but counted on the OP to not know it. It sounds to me as though she had it in for the OP to one degree or another all along, and worked to build a case against her from the beginning. The OP should have taken this to her union from day one, but I say that with more than 20 years of experience under my belt and 20/20 hindsight.

Looking back, I feel like I never had a chance once the fact that I was expecting was revealed. I did go to my union right away, but my union wasn't very strong and I actually think that made things worse for me. My NM really had it out for the union, as well. Our union steward was driven to quit a couple months before I did. So, then I had two strikes against me- the pregnancy and the fact that I was working with the union.

At this point, I am preparing the consult with an employment attorney in order to get the NM to stop defaming my character and lying about my eligibility for rehire. Hopefully, that should be fairly easy since what she's doing is illegal as well as against the hospital's policy. She should not be giving out references of any kind- let alone ones that are lies.

So after that I will be ready for a job search.

PLEASE START DOCUMENTING! You need dates, times, and any witnesses. Sit down and document them! Especially document your interview in which this NM asked about your race (BIG NO-NO!) and stated that calling in to take care of children annoys her (discrimination against people with children). Write this down. Call a lawyer who specializes in labor law. You could possibly have grounds for a lawsuit. I wouldn't want to go that route, but you need real legal advice about how to handle this situation without it getting uglier than it already has. You also want to make sure that this horrible experience does not haunt you when you search for another job. It sounds to me like your NM does not know the law (what a surprise in OUR profession NOT!) and is banking on your not knowing it either. Do some soul-searching about whether or not to actually sue. This information does get out in the community and you don't want to be wrongly labeled a litigious trouble-maker. None of the things you've done have resulted in harm. Nurses do make mistakes. No, you are not paranoid. Your NM IS out to get you because she doesn't want to pay maternity leave. This means they are not going to be treating you any better once the baby is born. You probably have enough to show cause right now, but you need to write EVERYTHING down with times and dates. Get legal advice and see about obtaining letters of recommendation from others besides your NM to show to other prospective employers. It's time for you to leave a paper trail. I was kicked to the curb after surgery (it was a big one) because the doctor would not release me to go back to work after four weeks. I did not pursue it. I probably should have and wish that I had now. They didn't fire me. They "filled my position to serve the needs of the elders" was how they put it. Never mind I gave them 14 hours a day 6 days a week of my life (on salary). Get REAL REPRESENTATION and show your teeth. Find out your options before you take any major actions. And by all means, GET OUT OF THERE! You're working for bad people.

sounds like they didnt train you very well, and your NM needs to be more supportive! a blame free environment is the best way to go.

I have to say after reading your blog. You seem to be riddled with excuses and mishaps. First, you promised to work not knowing what your pregnancy may bring(your fault) Two, your excusing your med errors due to not knowing ( one mistake can cost someone their life)(your fault) three if any one falls, gets hit in the head, Neuro checks is a nursing measure( your fault). You need to mature and accept your responsibilities. I believe your NM has given you a second chance by giving you a positive evaluation. But remember he/she is looking out for the interest of the hospital and protecting it from lawsuits. Which right now if you were in my staff I would consider you a liability. Not knowing is a poor excuse, every nursing unit has a policy and procedural manual, during your down time read and I can guess quit complaining about your NM. Hope your baby does wellbook.pnglisten.pngagreement.png read,listen and accept your respnsibilities good or bad.

Specializes in corrections, psychiatric.
:D

As I said, I think this is personal, not your job performance.

I don't know whether it is altogether personal. I do believe the nurse manager wants you to leave but it could be because of your physical limitations. It's very hard to staff a unit when nurses have limitations or there is the anticipation of long periods of absence. We do not use staff who are not 100% fit for duty at the prison because of the risks of being involved in a use of force with an inmate. At one point, we had three nurses on paid leave and the other nurses were constantly being mandated to cover their shifts.

However, I think the NM is using your errors to make a case for dismissal. I am confused about the good evaluation, but that is probably because you told her you were going to file a hostile working environment.

I would leave... but that's me!

Thanks for the replies. With the exception of the hostile one, of course. I didn't post this blog to be insulted and I don't feel a need to waste time defending myself. That said, I have left the position several months ago and am currently looking for a job that works with my schedule. I feel that pretty much everything that can be said about the situation has been said. There have been no recent changes. I know that my NM has given out a false reference about me, but have yet to contact an employment attorney to resolve it. I know that HR is giving me a positive reference. So that's who I am listing when I apply for jobs.

Sounds like you are taking the right steps, best to put this ugly episode behind you. Nursing doesn't have to be all bad. Give your baby a big kiss for me. Your priorities are in order.

+ Join the Discussion