Well, I thought I was doing ok. I thought the only thing I had to work on was time management, which would come with time right? I've been on the NICU less than 4 weeks and I was told this morning I wasn't a good fit. I'm a "very nice person" but my attention to detail isn't good enough right now and it is felt that with time my skills will be good enough...but not right now. Pretty much, I'm a nice person to talk to but I suck as a nurse. I hadn't been written up and as far as I knew from my preceptor I just needed to get used to working with little ones and my time management. My skills were fine. I've been out a few days with a stomach virus, so I get told this over the phone so I didn't have to come in on a off day. Which as of this morning is everyday.
I thought I was doing ok, I had gotten three arterial sticks, two IV starts (actually got one of those), and got to actually hold a feed two little ones last week. Now I find that I am not a good enough fit for them and honestly from my perspective this come out of the blue. No warning that I was doing that poorly. I know my preceptor had to repeat herself on certain things, but I think I'd eventually get it the more I did it.
I am supposed to take my boards next wed. Being told in a nutshell that your skills are lacking as a nurse, that your "really a sweet person" doesn't do much for my confidence.
I'm angry, hurt, humiliated, and wondering if I shouldn't just give up on being an RN since the first job I get doesn't think me much of a nurse anyway.
What I don't understand is why, if I had so many deficiencies, didn't they give me the chance to know about them and fix them?
I still want to work NICU, I actually enjoyed going to work...something that hasn't happened in a very long time. So what do I do now????
I think the manager (or whoever) that called you to let you go gave a horrible speech. With extreme circumstances like these (only on the unit 2 weeks and doing what sounds like a good job...) you should be given a detailed description of why this is necessary. After this is all said and done and you get what you need as far as things to do better/change in your practice, is there someone higher up that you can consult?
Would your precepter be open to having a sit down meeting with you and the manager to discuss the progress you had made and why it couldn't go any further? That would be helpful.
You will be able to focus all that energy on NCLEX now and pass with flying colors! One step to getting a new awesome job because you will have a leg up by already being board certified.
I have a theory... when I was on orientation, I was told by my NM not to call out sick w/o a death certificate. Cute, huh? You mentioned you'd been out a few days w/ a stomach virus. Now, obviously it's absurd and draconian and WRONG, but I wonder if the NM of your unit has a similar philosophy.
My NM called on Tues to ask for a meeting the next day I worked and I told here that I had missed that day because of a stomach virus. All she asked was if I had made sure I had gotten a note from the Dr. She said if I still wasn't feeling well the next day to let her know and we could meet later that morning. She said definately to not go if I still had symptoms. I called her yesterday, and she decided to tell me over the phone instead of having me drive all the way in.
Something really does stink about this, especially since the only time I'd been called to speak to her was over something that had nothing to do with nursing or patient care. Apparently someone complained to her that I had a "hygine" probelm, which was very absurd IMO. I think I will call and ask her to put in writing exactly what I need to work on since she has decided to let me go 4 weeks in. I do wonder how the other New Grads on the unit are faring since they have NO nursing experience what so ever? Are they more up to snuf that I was?
I've been trying to get ahold of the nurse rentention counselor, but he's been out the past two days.
One good thing is I faxed my completed clinical internship form in to the KBN today. At least I wasn't let go before I had completed my 120hrs. Of course, that's pretty much all I had been on the unit for....
I'm still confused how, at only 4 weeks into your NICU career you are let go for not being up to par.... were any of us up to par a month into our NICU experience?
Go into work, ask to speak to the manager that let you go, and find out what happened. You owe it to yourself. How can you improve without feedback?
I'm still confused myself. I keep thinking this is a bad dream and I'll wake up. The more I think of it the angrier I get. I thought a preceptor was supposed to inform you if you were doing that poorly before they would inform the NM that you don't have the skills. Especially as I was told my nursing skills were fine, that I needed to get used to working with/on little ones. And I was. I was getting used to repositioning, measuring, swaddleing, securing into a snugglie a 2 1/2 pound sweetie on a vent. It was much easier Saturday since he was no longer in an isolete. I was getting used to how everything went thru his IV on a syringe pump. I was getting used to doing the calculations on TPN and was starting to remember the formula to do so. I had done three arterial sticks, only one unsuccessful. the one that wasn't I was in the right area just too close to the wrist. My preceptor didn't say anything to me Saturday to even hint that I wasn't doing well, or that I wasn't a "good fit". And my preceptors judgement is what the NM based her decision on. I've had two and the other I only spent two days with on the CCN with two grower feeders so how she could judge me that fast I have no idea. Actually how my main preceptor could judge me in 128 worked hours that I wasn't a good enough fit is beyond me at the moment.
I hope when I do call the NM that she can put into writing exactly what my deficiencies were.
Four weeks is NOTHING. Were you already off orientation after four weeks? Where was your preceptor to help you with things like time management?
You DEFINITELY need to make sure you get a "exit" interview. You need to have them show you exactly what led to this decision. Like other poster said, tell them you would like to know what you can do to improve.
It sounds to me though, that you should go to another place. I would personally NOT want to work in a NICU where new nurses are treated like you are being treated.
Stay strong, ROCK YOUR BOARD EXAM, and make sure you go out of there with all your questions answered.
The NM called me this morning after talking to HR to give me a chance to ask questions. I asked her if I could have in writing my deficiencies. She didn't know if she could, but would talk to HR. Anyhoo, I asked exactly what were the problems. The boiled down to...
1. I was too slow. I took too long to do my assessments.
2. I kept having to be told the same thing over and over. Or I would ask the same type question over again.
3. I didn't seem to be receptive to learning since I didn't seem to be getting it.
4. I had to be reminded to answer alarms.
5. I was too slow. I had to be reminded to keep baby warm while doing assessments.
6. I made a comment about how I would be glad to get to my actual shift because it would be "slower". Ummm I'm not that stupid.
I know my time management needed work and it took me longer than my preceptor to do assessments. They aren't easy when your patient won't hold still, but I thought I was getting faster. Sorry I couldn't do it in less than 5 minutes. I did learn the trick of doing the b/p and the temp at the same time. As far as asking the same question, thats how I learn...I'll keep asking until I know I've got it. Yes, you might have to repeat yourself....but sheesh, I had never done some of these skills before. Like the TPN calculations. If I was charting I didn't hear an alarm for a few seconds, then I'd turn to find out which alarm was going off. Of course my preceptor would hear it seconds before I would and say something.
The NM pretty much said I needed to gain more RN experience/critical thinking skills in another area, maybe med/surg then I could re-apply. Personally I doubt it.
Personally I think I would have gotten faster if given the time. But they figure that since orientation is 6-9 weeks at the most, if you haven't started to get it after 4 weeks you aren't likely to. No classes other than NRP and Stable, which NRP was the only thing I'd completed. Everything else was in a HUGE binder to read, but your main learning is on the unit itself. I felt I was finally getting the TPN calculations.
The nurse retention counselor returned my phone calls a few minutes after I got off the phone with the NM. He said that since I was terminated I had to apply externally, and would I be amiss to working the type of units I worked on as an LPN. He said to apply to as many positions that interest me. Hopefully I'll get something, even though I have to list the job I just lost. He also said it will be an uphill battle, even once I pass boards though passing them will make things easier. Also terminated for "failing orientation" isn't the worse termination to have. Which doesn't make me feel any better.
I'll just be glad to have my boards over with. Oh and get this, the NM suggested that perhaps having boards to worry about might have contributed to me not being totally focused on what I was doing...grrrrr. I was totally focused. Tired, but focused. Getting up at 5am when your used to working nights was very tough.
One thing I have learned is to not trust your preceptor to have your best interests or to actually help you, you know give tips on how to do assessments faster instead of saying you'll get faster with time.
Just out of curiousity your unit hasn't been through a period of low census or anything like that has it?
Not really, though right before the group I started with actually started they were bursting at the seams. Three of us started together, all new grads. I wonder how they will be judged, or did I get the perfectionist preceptor.
One thing I have learned is to not trust your preceptor to have your best interests or to actually help you, you know give tips on how to do assessments faster instead of saying you'll get faster with time.
IMHO... you SHOULD be able to trust your preceptor to have your best interests in mind. Their main job is to ensure that you have the skills (and confidence) to succeed. I am one of the preceptors on my unit, and I would much rather have somebody who asks questions about what they are doing instead of just jumping in head first with out knowing what they are doing.
I have never heard of somebody being "asked to leave" because they weren't getting it after just 4 weeks. That is why (our) orientation is at least 12 weeks long. You're not going to be an expert right away.
A few years ago I co-precepeted this one girl on my unit. At about week 8, it was becoming apparent that she truly wasn't getting anything. After her other preceptor and I talked about it and tried to fix a few things on our own, we sat down with her, and our manager to discuss things. It was decided that she just needed more time, and that working nights was killing her. So she switched back to days (for orientation at least...). She then was given extra orientation time (16 weeks total instead of our usual 12). At that point, she still wasn't getting even the most basic skills. Only at that point, was she told that our unit wasn't a good fit for her.
Now I don't know the details regarding how your unit works, or anything like that. But I wouldn't want to work somewhere that treats its' new grads in that fashion. It seems like they aren't interested in teaching you, that you are expected to know everything right away after the first time hearing / learning it.
Go pass your boards and then concentrate on finding a unit that will work best for you.
I'm sorry but from the info you've given us, they are full of it. @ the very least, they should have let you work a couple more weeks. No one "gets it" after 4 wks. And they shouldn't be expected to, either.
Don't let this throw you. If I were you, I'd beat feet to another hospital.
Our unit has fired a number of orientees over the last couple of years, but only after they've made serious errors in judgment. Sleeping at the desk (yes, really), massive med errors coupled with blase attitudes about them, stuff like that. We don't fire people for being slow, and we're... not known for being the most welcoming unit.
My thought is that even if the things your NM told you were really why you were let go, you seriously don't want to work on a unit with that kind of culture.
Other than studying so I can make sure to pass my boards I don't really know what to do now. I can apply for any other position within the hospital system, which I'm doing. Once I have my permanent license I'll be able to apply anywhere. Though were? I mean, should I apply out of state to try to get the position I want or take what I can get around here? Of course I can't really do much of anything until I take and pass my boards...2 days and counting btw.
I am really the most confused person in world right now, I really am.
Remember, if you go out-of-state, you need to get your license in that state as well. It's just more money, you don't have to re-take the NCLEX, but it can take awhile for the paperwork to get processed.
RN4Little1s
113 Posts
I think the manager (or whoever) that called you to let you go gave a horrible speech. With extreme circumstances like these (only on the unit 2 weeks and doing what sounds like a good job...) you should be given a detailed description of why this is necessary. After this is all said and done and you get what you need as far as things to do better/change in your practice, is there someone higher up that you can consult?
Would your precepter be open to having a sit down meeting with you and the manager to discuss the progress you had made and why it couldn't go any further? That would be helpful.
You will be able to focus all that energy on NCLEX now and pass with flying colors! One step to getting a new awesome job because you will have a leg up by already being board certified.