So I am a new nurse and I was fired from my first job after a month. My preceptor and I didn't get a long and as much as I tried to figure out ways, we clashed a lot. I didn't want to get my manager involved just yet, but by the time I felt it was necessary, it was too late. I know I can come off strong, and when I am confused about something, or felt that it was unsafe, it was easy to question my preceptor because I didn't feel comfortable. My preceptor had a few times went outside the scope of practice and that ruined my faith in them, and often times would force me to change my assessment to something that I felt was an inaccurate picture or left things out that I felt were necessary to give a bigger and more accurate picture of the patient. In addition, I felt I was scolded from checking my patient too often (who were kids btw) when the alarm would sound, and then I erred by not checking them enough and couldn't seem to find balance to them. Also, I felt I was misaccurately represented to my manager, and when I would explain what happened they would say, "that doesn't sound like so and so" and I realize that human nature tends to trust those who know in longer, but it sucked. Another instances, I had checked the a pt who needed more O2, because O2 was low, and I stimulated them by tapping on their chest ( as shown to do) and checked their mask and it didn't increase their stats so I increased the O2, but was then told I didn't assess enough before deciding to increase O2, and should have called my preceptor before doing that, when it felt that my preceptor had put me in charge of this particular patient when a friend went on lunch and did what I was instructed to. I was told I was being confrontational when I said, "I was doing what I was instructed to do to keep their sats up" too loud when my preceptor scolded me from doing that...and now I find myself without a job, and it was already hard to find a job as a new nurse, now even more difficult for being let go from my first job....I am not even sure how to recover from this or anything...
Thank you. As mentioned way early in the posts, I originally didn't want to talk about the out of scope part since it was dealt with under where I worked, and managers said it was out of scope (at least at this hospital), and not okay to take from other patients medications. In this case, that is all that matters, moving on.
I will say it again--there is a difference between nursing school nursing and real world nursing. You have not been around long enough to realize that. That's not an insult. That's just reality. I agree there are some things that cannot be compromised. But you will find out that nursing is not always black and white. It is usually various shades of grey.
I erased my previous post because you seem very rigid in your thinking--unwilling to even consider any other point of view and I thought it futile to even try to communicate with you. I'm not even sure why I'm trying again to reach out other than you said you were trying to learn from your mistakes. So, call me an eternal optimist but I'll try again.
There will be times in your nursing career when the text book way of doing things will not work. Hospitals are full of system failures and those failures will keep you from effectively doing your job and providing the best care for your patients. You will have to learn ways around those system failures. And yes sometimes that may mean temporarily borrowing medication from one patient's supply to give to another patient. Same medication. Same dose. Your other option is to be written up for a medication error for a missed dose. And/or allow your patient to needlessly suffer uncomfortable symptoms or side effects from not receiving their medication as ordered. Sure you can fax a zillion missing med forms to pharmacy and call them umpteen times--like you have all day to do that? You can fill out incident report after incident report but eventually you figure out it's not going to change anything. (By the way, I'm not talking about the particular incident at the hospital you were fired from. I'm talking about your blanket statement that it is never okay under any circumstances to take medication from another patient's supply.) When I was just out of school I thought the same thing. I'm a rule follower too. But sometimes following the rules doesn't work. Sometimes you have to think creatively outside the box. Should it be this way? No. Is it this way? Unfortunately, yes.
You can continue to try to prove to everyone here how right you were in your actions and how wrong they were to fire you (and that may very well be the case) or you can listen to wealth of knowledge that comes from years and years of real world experience from the nurses here who are taking the time to try and help you. Your choice.
I do hear you. I think it would suck for someone to be written up for not giving a medication that was not available as long as they took the steps necessary to obtain that medication from pharmacy, such as in EPIC you can send high priority for medications, and yes, you can call them. I am sure it has happened, while I may have difficulty being okay with that, I do understand that it happens. In high priorities rules become very blurred and aren't as black and white. I wish nursing school would more have prepared people for the actual work force also rather than just in ideal circumstances as I felt my education was. Since I am a ruler follower (and to a certain degree in different circumstances, I need to get out of that to become more flexible) it made it really difficult to trust when people break those rules that one was taught in nursing school. However, obviously that didn't work in reality following rules the way that I did, and realize when TJC comes rules have to be played again, it is fuzzy, which not entirely happy about that, but I can work with it.
I do hear you. I think it would suck for someone to be written up for not giving a medication that was not available as long as they took the steps necessary to obtain that medication from pharmacy, such as in EPIC you can send high priority for medications, and yes, you can call them. I am sure it has happened, while I may have difficulty being okay with that, I do understand that it happens. In high priorities rules become very blurred and aren't as black and white. I wish nursing school would more have prepared people for the actual work force also rather than just in ideal circumstances as I felt my education was. Since I am a ruler follower (and to a certain degree in different circumstances, I need to get out of that to become more flexible) it made it really difficult to trust when people break those rules that one was taught in nursing school. However, obviously that didn't work in reality following rules the way that I did, and realize when TJC comes rules have to be played again, it is fuzzy, which not entirely happy about that, but I can work with it.
There is a definite disconnect between the idealism of nursing school and the real world of nursing. Nursing schools--even really good nursing schools--don't prepare you for real life nursing. I know mine didn't. Most new nurses experience a significant reality shock in their first year of practice. It can be a tough adjustment. The first six months were tough for me. I worked nights and started on an inpatient oncology unit. I actually loved nights (night owl) and I grew to love oncology but it was a steep learning curve.
Nursing definitely has it's issues but it's still an awesome career.
And yes, flexibility is a must! Best at of luck to you.
You consistently mention the managers are in complete agreement the incidents were out of 'scope of practice ', the same managers elected to have this nurse precept you and valued the preceptor's evaluation of you. Some how it does not add up.Working is not nursing school, it sounds like this job was not a good fit for you, time to move on.
Yes, my managers sided with me on the out of scope of practice, but did still choose the preceptor over me and it makes perfect sense, they've invested a lot of time, money and energy into them more than me and human nature tends to value the those opinions we've built a relationship with over a newer relationship, just part of our nature. Also I would be the most expendible due to being the most new and less skilled of the two. While it may not add up to you, that is okay. It is what it is, and I do need to move on. While I do feel that I would have thrived with a different preceptors whom I worked with side by side in different situations and they taught me well on certain skills, that doesn't really matter either since doesn't change the outcome now. The reason I had written the original post is more due to trying to figure out how to move on, and figure out how to pursue my next job since it was already difficult to get a job as a new grad, let alone someone who was let go.
Yes, my managers sided with me on the out of scope of practice, but did still choose the preceptor over me and it makes perfect sense, they've invested a lot of time, money and energy into them more than me and human nature tends to value the those opinions we've built a relationship with over a newer relationship, just part of our nature. Also I would be the most expendible due to being the most new and less skilled of the two. While it may not add up to you, that is okay. It is what it is, and I do need to move on. While I do feel that I would have thrived with a different preceptors whom I worked with side by side in different situations and they taught me well on certain skills, that doesn't really matter either since doesn't change the outcome now. The reason I had written the original post is more due to trying to figure out how to move on, and figure out how to pursue my next job since it was already difficult to get a job as a new grad, let alone someone who was let go.
A simple incident as you described wouldn't normally result in management having to choose between you and your preceptor.
It really could be a matter of a simple corrective action- or not. If they value that employee as much as it sounds like, then no formal corrective action absolutely has to take place. Verbal counseling is an option at the manager's discretion. And had you shown potential to be an asset to the unit, they would have held on to you and found a way to make it work- whether by assigning a new preceptor (even if they are few and far between, that does not equate to impossible) or keeping you with your current one, working with the two of you to develop a plan, and scheduling frequent check-ins with you both.
The fact that they chose to fire you instead of working with you tells me that your rigid, inflexible, and challenging behaviors were red flags signaling that the likelihood of you fitting in and being a part of the team was slim, so they saw the writing on the wall and decided to let you go before investing any more resources in you. This wasn't a matter of choosing anyone over you. They let you go based on your demonstrated behaviors.
I do hear you. I think it would suck for someone to be written up for not giving a medication that was not available as long as they took the steps necessary to obtain that medication from pharmacy, such as in EPIC you can send high priority for medications, and yes, you can call them. I am sure it has happened, while I may have difficulty being okay with that, I do understand that it happens. In high priorities rules become very blurred and aren't as black and white. I wish nursing school would more have prepared people for the actual work force also rather than just in ideal circumstances as I felt my education was. Since I am a ruler follower (and to a certain degree in different circumstances, I need to get out of that to become more flexible) it made it really difficult to trust when people break those rules that one was taught in nursing school. However, obviously that didn't work in reality following rules the way that I did, and realize when TJC comes rules have to be played again, it is fuzzy, which not entirely happy about that, but I can work with it.
BRAVO! After slogging through this thread, I was delighted to come to this post.... OP is definitely revealing insight that was missing in previous posts.
New nurses launch their careers with very limited frames of reference because "clinical" isn't the real world. This is particularly evident when they begin their career in a specialty area that is not given much emphasis or time in nursing school- such as OP, who was apparently working in peds.
OP has openly identified a tendency toward rigid thought patterns & difficulty adapting. That's wonderful insight. All of us COBs should be cheering him on. One additional suggestion that may be relevant if the OP is male (as suggested by the avatar)... Some male nurses are absolutely unaware that they appear to be overly aggressive/confrontational simply due to body language - especially if there is a significant size/height difference. Just food for thought.
A simple incident as you described wouldn't normally result in management having to choose between you and your preceptor.
It really could be a matter of a simple corrective action- or not. If they value that employee as much as it sounds like, then no formal corrective action absolutely has to take place. Verbal counseling is an option at the manager's discretion. And had you shown potential to be an asset to the unit, they would have held on to you and found a way to make it work- whether by assigning a new preceptor (even if they are few and far between, that does not equate to impossible) or keeping you with your current one, working with the two of you to develop a plan, and scheduling frequent check-ins with you both.
The fact that they chose to fire you instead of working with you tells me that your rigid, inflexible, and challenging behaviors were red flags signaling that the likelihood of you fitting in and being a part of the team was slim, so they saw the writing on the wall and decided to let you go before investing any more resources in you. This wasn't a matter of choosing anyone over you. They let you go based on your demonstrated behaviors.
They did view me as confrontation and as HouTx mentioned, it could have been the fact that I am male, and I am a rather large male and I could see how that could make things a little different in how I should approach things, making need to be more gentle in spirit. Also, sometimes the preceptor is exactly how someone describes and not always the individual. Case in point, got along with all other nurses on the floor, and all other nurses I'ved worked with in the past in nursing school and on the floor. Sometimes it really is the preceptor. I tried many times to work with this preceptor, I tried seeking her help many times and being shut down for asking questions and told not to ask questions doesn't exactly help any situation in a learning environment. Having someone feel that you were not part of the team, but felt shamed and overshadowed is not a helpful environment. I've had plenty of nursing instructors, other nurses on the floor, other nurses from other hospitals able to help me, teach me without doing those things.
However, as mentioned in previous posts, there are a lot of ways that I could have done things differently and I will take a lot of what I have learned away from this. Also, I am not even sure why they hired so many people since the boss told me they only had 3 spots and decided to overhire by hiring over 8 people. Not exactly a motive in keeping someone or working with them. I've tried to explain to them what really happened, but I had found numerous times big parts of the story were missing from what my preceptor reported, which didn't help the situation. It is what it is, I will get through this and move on.
This is my last post. No longer going to read these posts, or comments. I feel that people are not getting the original reason why I made my posts, and not being supportive as I would have hoped. However, I do thank many for their comments. I do realize that the nursing world is very different than the school world, and I guess I had to hit reality hard on that one. I look forward to growing as a nurse. Thank you all.
You have not given one example of how a patient's safety was actually at risk through the actions of your preceptor. It sounds like you got called on your own actions and tried to put all the blame on the preceptor who obviously is an experienced nurse while you are not. That's not cool. You seem to have a lot of hostility in you and that's what you need work on.
Yes, my managers sided with me on the out of scope of practice, but did still choose the preceptor over me and it makes perfect sense, they've invested a lot of time, money and energy into them more than me and human nature tends to value the those opinions we've built a relationship with over a newer relationship, just part of our nature. Also I would be the most expendible due to being the most new and less skilled of the two. While it may not add up to you, that is okay. It is what it is, and I do need to move on. While I do feel that I would have thrived with a different preceptors whom I worked with side by side in different situations and they taught me well on certain skills, that doesn't really matter either since doesn't change the outcome now. The reason I had written the original post is more due to trying to figure out how to move on, and figure out how to pursue my next job since it was already difficult to get a job as a new grad, let alone someone who was let go.
You would have "thrived" if you did not call out your preceptor that their actions were "Completely unacceptable."
News flash... the five rights are not written on the Rosetta stone. Experienced nurses do what needs to be done.
"There is the 5 rights in medication administration to. You wouldn't be able to go through the 5 rights if the names do not match. Completely unacceptable.
And some states does allow the PCA to aid a pt in administering meds, however, with babies, I strongly am not okay with them administering meds. Other than "handing the meds" to the pt, while I stay in the room and see that they hand the meds to them. I am not comfortable with that under my license if I would have left the room. In addition, I need to be able to assess the patient before administering and might as well administer myself. I am very uncomfortable with the practice of having UAPs give medications, and will not under my license."
I think I'm beginning to understand why the OP was let go...
Cricket183, BSN, RN
1 Article; 268 Posts
I will say it again--there is a difference between nursing school nursing and real world nursing. You have not been around long enough to realize that. That's not an insult. That's just reality. I agree there are some things that cannot be compromised. But you will find out that nursing is not always black and white. It is usually various shades of grey.
I erased my previous post because you seem very rigid in your thinking--unwilling to even consider any other point of view and I thought it futile to even try to communicate with you. I'm not even sure why I'm trying again to reach out other than you said you were trying to learn from your mistakes. So, call me an eternal optimist but I'll try again.
There will be times in your nursing career when the text book way of doing things will not work. Hospitals are full of system failures and those failures will keep you from effectively doing your job and providing the best care for your patients. You will have to learn ways around those system failures. And yes sometimes that may mean temporarily borrowing medication from one patient's supply to give to another patient. Same medication. Same dose. Your other option is to be written up for a medication error for a missed dose. And/or allow your patient to needlessly suffer uncomfortable symptoms or side effects from not receiving their medication as ordered. Sure you can fax a zillion missing med forms to pharmacy and call them umpteen times--like you have all day to do that? You can fill out incident report after incident report but eventually you figure out it's not going to change anything. (By the way, I'm not talking about the particular incident at the hospital you were fired from. I'm talking about your blanket statement that it is never okay under any circumstances to take medication from another patient's supply.) When I was just out of school I thought the same thing. I'm a rule follower too. But sometimes following the rules doesn't work. Sometimes you have to think creatively outside the box. Should it be this way? No. Is it this way? Unfortunately, yes.
You can continue to try to prove to everyone here how right you were in your actions and how wrong they were to fire you (and that may very well be the case) or you can listen to wealth of knowledge that comes from years and years of real world experience from the nurses here who are taking the time to try and help you. Your choice.