Trials

[anony8204]

Hi,

I have been a nurse for over 5 years and have run into some bad trouble that I am doing my best to prepare for. I have never been in trouble before but about a year ago I worked at a local hospital that I thought would be a good opportunity for me to learn some new skills, I quickly realized that this was not the case. I was shunned by a majority of the nurses, I was almost bullied by others. I rarely could find help when I needed it as I was working in a facility with new equipment, technology, and computer system. Going to work became very stressful and I became depressed, confused and upset. I wasn't taking care of myself and stopped eating, sleeping, and taking fluids. I thought that if I just worked hard and proved that I belonged there that things would get better, but they got worse. I admit that I made mistakes. 4 actually and 3 of them were minor, the last one was more of a major mistake but the individual in the case was not hurt and I learned a valuable lesson. One week I was brought into the manager's office and was given papers that had every mistake that I had made from my time at orientation until that day when I decided once and for good to quit. She told me that I was being reported to the board for my mistakes and that I was "toxic" to the rest of the workers and that they had consistently reported to her that I was standoffish, sullen, and withdrawn when it came to interacting with the rest of staff. She also stated that I was "messy" with my nursing skills and that I didn't fit in with everyone else. I was devastated, I was shocked, and I was upset, to say the least. I put in my notice that day but of course, the damage was already done. I am currently looking for employment as I have hired a lawyer to represent me on my behalf with the board. I was told that I needed to find employment where I can be "supervised" as in a worst-case scenario I may have restrictions placed on me by the board. I currently work in home health and I know this is not a supervised position so I am now scrambling to find a job before I lose the one that I have. I am fighting depression and anxiety and I am in a master program that I am not even sure I should continue. You need a nursing license in order to use this degree anyway. Does anyone know of anyone else, or have you yourself gone through a situation like this and have any words of wisdom or encouragement? I am trying to be strong and pray and rely on my friends for support, those who know. I feel so embarrassed, and forlorn, and cry constantly so haven't shared this with many people. I'm hoping that maybe someone out there can offer me some comfort, in the least and may help me through this difficult time. Thanks in advance! You are appreciated more than you know!

[canoehead, BSN, RN]

So, I don't know you, and you might suck as a nurse, but my gut says you don't. Everyone makes mistakes during orientation, that's why they pair you with a preceptor. New nurses don't tidy up behind themselves like old cranks because they are on information overload all the time. Eventually you will get used to your workload, and start seeing the wrappers or loaded garbage can, but right now all your attention is on your patients, and, you know, not killing anyone.

If you are getting criticized from all sides, instead of encouraged and taught, well, yeah, you'd be standoffish and sullen. That's not good, and its something to work on, because you won't be able to connect with the good teachers if you don't talk to them.

You were overwhelmed...that's my opinion, what I get from what you said. It doesn't make you a bad nurse or a bad person. Perhaps one of your errors was serious, and you need to reflect on it. But your preceptor should have been easing you along in a way that you didn't get in over your head, or at least you had someone to jump in before a serious problem occurred.

You still need to work hard and self reflect to improve. Try again, and you'll notice how much you learned when you go to the new orientation.

[NICU Guy, BSN, RN]

4 hours ago, anony8204 said:

I was told that I needed to find employment where I can be "supervised" as in a worst-case scenario I may have restrictions placed on me by the board.

Who told you this, your former employer? Unless you were fired for gross negligence, the BON has far more important things to deal with than your issues. I wouldn't hire a lawyer until you hear from the BON (which is very unlikely).

[anony8204]

I received this knowledge from my lawyer. I hired him because I was reported to the BON and they responded. I am being formally investigated at this time. I am very scared and feeling awfully low these last couple of days. I don’t know what to expect or what to do. Please keep me in your prayers.

[traumaRUs, MSN, APRN]

Oh gosh, first take a deep breath. Let your lawyer work for you. Also, as you admitted, you are depressed and upset (and this is natural considering the circumstances). Have you had a complete physical? How about some counseling? I'm gathering there are no substance abuse issues? Or if there are, start going to meetings; AA/NA or something.

Please talk to someone in real life too - do you have a close family member or friend that you could bounce things off of?

I'm truly sorry you are going thru this - please take care of yourself.

[Jory, MSN, APRN, CNM]

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[ruby_jane, BSN, RN]

Until you get a signed order from the Board, you can (and should) continue to work, continue to develop a pattern of successful practice, and do the best you can. Your interpretation of what your former manager told you does not point to specific flaws in practice but I would encourage you to consider if there is some kernel of truth in there. Do you need some remediation in medication management? Time management? Can you take a course?

Prepare yourself, because this could take years to work through. Hang in there.

[anony8204]

No. No drug issues or diversion or anything like that. I didn’t check a blood sugar within 15 min, a pt was on tpn q24 hours and instead of removing a new bag and hanging a new one at 8pm I allowed the current bag to hang and put up a new bag when the old one was completed, I hung the wrong fluids and it ran for 20 min before I caught the mistake, I also had a pt who was on a insulin pump who had had surgery and ended up going into DKA and had to be transferred to a higher level of care. These are the charges against me. I am doing my best to pray, meditate, work, do my homework as I am in a masters program at this time, eat and sleep (these have been very hard for me) and do everything my lawyer says. I have had my former coworkers write character letters for me and I have spoken to one of them in depth about how I feel and she has been an enormous support and comfort but I am terrified and completely embarrassed about having to tell those I reach out to about what is happening. I am doing my best to move forward in a positive light. This is the first time in 5 years my judgement and character have been under attack so it’s pretty devastating to be honest. I do appreciate all of your advice and suggestions and your kind words. So thank you!

[2Ask]

To report you to BON for the first three of those is ridiculously nit-picky! Sounds to me like a case of lateral violence- they had it out for you and found anything and everything they could to report. I'm sorry your manager did not have your back.

I have done things equivalent to those during my 90 days of orientation and did have other nurses that reported me and wrote nastygrams. In my case, my errors had to do with the unfamiliar computer system where there was not a visible flag/reminder for meds and I missed meds on a couple occasions and gave a PRN too close on another.

During orientation, I was also reported for "not being concerned enough about an ordered blood transfusion" and for "giving glucose tabs outside of the standardized hypoglycemia protocol parameters". When I reviewed the chart I was able to show the manager that the blood transfusion was COMPLETE by 1300 and I had multiple IV meds on that patient with limited IV access and had taken care of that too. "Help me understand this? How soon after an order is placed do you expect the infusion to be completed? Our protocol is to infuse the blood over 4 hours and I had started it by 10". And the glucose tabs- the patient was not a diabetic, had eaten a full tray and was not hungry, had received 10units of IV insulin with 25ml of D50 in the ED and was dropping at every sugar check. I gave him the glucose tabs for a BG of 70 near shift change. It was a critical thinking decision in the patient's best interest- not a "med error" and the chart showed no hyperglycemia but normal prost-prandial levels for the night shift. But they still reported it as a "med error".

In my case my manager had my back. I'm an older nurse and frankly I think there was age discrimination, false assumptions, and disrespect motivating the nurses that had it out for me. It made me angry and I collected all the assignment sheets and looked at acuities and found that I had the highest acuities of anyone else on that unit during my orientation and was handling it very well- I did not feel overwhelmed. They were hazing me I think. I didn't ultimately have to use that information to defend myself because the manager had my back.

Missing an insulin pump on the surgical patient sounds like more than just a one person error. It's a system error and I'm sorry you were thrown under the bus for it.

[Lady_Leijing, BSN]

*hugs* That really sucks. I escaped a really toxic workplace about a year ago--though mine didn't report me to the BON. It hurts, especially when you're blindsided by a list of "problems" that no one bothered mention to you.

In addition to support from family and friends, I found a good counselor can really be helpful in addressing depression or anxiety.

Don't give up! You're not alone in this!

[AceOfHearts<3]

11 hours ago, 2Ask said:

Missing an insulin pump on the surgical patient sounds like more than just a one person error. It's a system error and I'm sorry you were thrown under the bus for it.

I agree with this 100%- it wasn’t just you that missed it. Your other mistakes are minor and should just require a review of policies.

[Ruby Vee, BSN]

On 2/11/2019 at 6:01 PM, anony8204 said:

No. No drug issues or diversion or anything like that. I didn’t check a blood sugar within 15 min, a pt was on tpn q24 hours and instead of removing a new bag and hanging a new one at 8pm I allowed the current bag to hang and put up a new bag when the old one was completed, I hung the wrong fluids and it ran for 20 min before I caught the mistake, I also had a pt who was on a insulin pump who had had surgery and ended up going into DKA and had to be transferred to a higher level of care. These are the charges against me. I am doing my best to pray, meditate, work, do my homework as I am in a masters program at this time, eat and sleep (these have been very hard for me) and do everything my lawyer says. I have had my former coworkers write character letters for me and I have spoken to one of them in depth about how I feel and she has been an enormous support and comfort but I am terrified and completely embarrassed about having to tell those I reach out to about what is happening. I am doing my best to move forward in a positive light. This is the first time in 5 years my judgement and character have been under attack so it’s pretty devastating to be honest. I do appreciate all of your advice and suggestions and your kind words. So thank you!

I'm glad you have a lawyer and you're following their instructions. I'm really glad that you have someone to talk to who is supportive of your feelings.

I don't know you, and I don't know your practice. Not checking a blood sugar within 15 minutes (unless you failed to check it for several hours) is a "so what?" sort of mistake. On an insulin drip, it would be a big deal, but not TPN. Wrong fluids -- also probably not a big deal if you caught it within 20 minutes. The insulin pump -- not sure I understand what the problem was there, if you overlooked that she HAD an insulin pump or what. But it doesn't really matter to my point.

My point is that more new nurse and nurses new to a particular job fail in their orientation because the established staff doesn't LIKE them than for any other reason. Often times it's just because the new person is anxious and too focused on the tasks to take time to be LIKABLE. I know this because I was that new grad who was nearly run out of my job and my career.

If people LIKE you, they will cut you some slack, even when the errors are huge. If they don't like you, you will wind up in all kinds of trouble even for minor errors. The takeaway is that you want people to like you. So, while you are at work, you pretend to be an extrovert; you act as if you like everyone you encounter and are thrilled to see them. You smile and say hi to everyone, every single time. You take 30-60 seconds to ask them about their commute or their garden or their dog or their kid every single day, even if you don't really give a crap. You introduce yourself to everyone until you are positive they know your name. That's hard work, but it is part of the work of starting a new job.

Trust me, I don't like this either, but it's the reality.