Almost Fired !

So...

I am a new nurse who has not been doing well at all in my new job. I am working on a Med-Surg floor with very high volume and turn around. I started working in late april and I am currently on an action plan because I had an issue with hanging blood. Long story short I know for sure I am not fit to work in such a hostile environment but I have held on this long for the experience and also because there are no job openings.

Now I am to write a statement to my nurse manager because she is going to nursing administration about a patient complaint. One of the night nurses e-mailed her stating that a patient complained of "red and swollen IV site" and also that I left an antibiotic hanging for hours without infusion. The patient failed to mention that she wanted to get up and ambulate in the halls so I couldn't infuse the antibiotic I also assessed the site before and after infusion and saw no redness or swelling. The night nurse also complained about a dressing on a mid-line of another patient being soiled and not changed. I assessed the patents mid-line initially in the AM and dressing was CDI, there were no IV infusions that day so I didn't check again. She also complained that I failed to fill out paperwork for a patients calorie count when I delegated the responsibility to the nurses aid and she assured me she would take care of this. It was never done this is the second time I've delegated and it hasn't been done. I feel sick to my core! With 6-7 patients its so hard to keep up with everything!!!

In other words I'm F-CKED !! I feel I'm always thrown under the bus and to the wolves working here no one comes and tells me when I'm not doing something wrong. Its always brought to "the higher ups" and result in write up or punitive actions. I'm currently suspended until further notice and am for sure I'm going to be let go. Nursing school and the nursing world are totally different entitites and I am having a very difficult time with the transition and support. Any thoughts or advice? I have to prepare a statement for nursing administration ....


PLEASE HELP!!
Sorry to hear about your situation. You're right, nursing school and work are 2 different worlds. Have you thought about maybe leaving this position, & considering something at a slower pace for a while, like clinic work? Maybe until you get comfortable and feel like less of a "newbie". Then you could maybe transition in to the hospital later.... I hope things work out for you.

what would be slower paced? I hear nursing homes you have 30 patients and extra charting. Plus, I can't get a job anywhere in my area without experience. I feel terrible!

They sound like typical new grad errors. When you delegate, always make sure that it does get done because you are responsible for it in the end. I know its all overwhelming, and time management is one of the hardest things to learn. Perhaps you could talk to your manager and ask to slow it down a bit. We only take 4 patients during the day and 5-6 at night. But we worked slowly to that point. I was only taking 2 patients on day shift and 3 on night shift, and after getting that slowly added another one to the mix and so on.

Seems it's quite common. You know, I'd just not think about the "next job" quite yet. You still have to play this one out. Are you still orienting? Whatever it is, I'd be sure to sit down and write your letter. If these things happened you have to own up and from what I read on this board, you probably also have to state how you plan to learn and move forward, you have to write actual actions you are going to take. Sometimes this and being humble buys you more time. I seem to understand from Allnurses posts that often as you near the end of your orientation, it's common for those nurses who just either don't like you, or have a friend who they want to work on your floor, to try to get rid of you. It might be a night nurse who is friends with someone on days who will accept the task of throwing you under the bus, anybody who is pals will do it without a second thought. You just have to decide if you want to stay or not. Sometimes, it helps you feel a bit more control if you write a resignation letter as well, all nice and full of thank you's for the opportunities provided, etc. and have it ready to email, and to hand deliver. Keep it on you in case you are pulled into some office. You never have to use it, but it's nice to have in case you want to whip it out should things get really bad and you want some control.

I'm against having the "I quit" letter handy at work. That makes it too easy to act on impulse and quit on a moment's notice. I support having it at home, but having it with you...well...that might not be in your best interest. It's always good to think something over and not respond in the heat of the moment.What's the statement you're supposed to write supposed to include? Since I don't know, maybe it would fit to state the facts, just the facts, without emotional content, and also include a plan for how you want to improve...again, the facts, just the facts. Do NOT blame anyone else for anything that happened.

Sorry to hear this. I just graduated in May and understand. As a new nurse you can't work anywhere but Med-Surg at a hospital. Everywhere else wants experience, heck most of the hospitals near me want experience for med-surg. I can say that April-June is very little time to develop those management skills needed to deal with all the patients needs, delegation, etc. I wish I could get 6-7 patients. We are expected to take 8-9 right out of school in a Med-Surg, some high acuity. Possible....yes....safe...no. Be strong, be honest, calm down so that no-one perceives you as whining (which gives them more of a reason to let you go), and rationally discuss this. Maybe this job is not meant to be.

Ever wonder why the position was open in the first place? If it were a great floor to work on there wouldn't be a position available, that's why it was offered to a newbie. Not picking , we all have to start somewhere. You were put in a sink or swim situation with lousy co-workers!! don't be so hard on yourself !! Hang in there! I know you can do it!! your co-workers only know how to talk to the nurse manager instead of you .

Well I disagree with that. I assume the OP is an intelligent person and understands. I am one to pretty much not act on impulse, that is why I have the letter ...so I don't have to, you see? It's best to control your situation, no matter what happens. Nursing admin more than any other (and I've worked with many) are very much to act on impulse, which is why the OP is in the situation she is in. You have to counter that aggression with calm on your part.

The OP begins by acknowledging that she/he is "not doing well" & this is a very positive step. However, as someone who has been in a similar situation many times, I can understand why the OPs manager is escalating the performance discipline process. From the information provided, it appears that a "pattern" of poor performance has emerged. I am troubled by the fact that the OP feels "I am always thrown under the bus and to the wolves" & characterizes the work environment as "hostile". This does not appear to be the case based on the information provided. Accepting personal accountability is always hard - no matter what the circumstance. For nurses, it's even harder because we tend to set unrealistically high personal standards so it's much more painful to 'own' the behavior rather than blaming someone else. Been there, done that (many times). None of us is perfect. We just need to forgive ourselves, learn from our mistakes and move forward. The OP would fare much better by taking accountabilty for what appears to be a series of omissions - most likely due to time management & prioritization which are skills that all new grads need to develop. If she/he goes into the meeting with a pro-active plan that includes specific corrective actions (e.g. always 'close the loop' when delegating by making sure the task has been done; always check and document IV sites at least two times per shift, etc.), the discussion may have a more positive outcome.

I stand by my opinion of not having the letter of resignation with you. If it's given to the boss in the heat of the moment, even if you feel calm in doing it, all you've won is the lack of a job.A while back I worked with someone who calmly quit during a meeting to discuss a problem. The next day the person changed mind, but the taking back of the resignation was not accepted.

Quote from HouTxThe OP begins by acknowledging that she/he is "not doing well" & this is a very positive step. However, as someone who has been in a similar situation many times, I can understand why the OPs manager is escalating the performance discipline process. From the information provided, it appears that a "pattern" of poor performance has emerged. I am troubled by the fact that the OP feels "I am always thrown under the bus and to the wolves" & characterizes the work environment as "hostile". This does not appear to be the case based on the information provided. Accepting personal accountability is always hard - no matter what the circumstance. For nurses, it's even harder because we tend to set unrealistically high personal standards so it's much more painful to 'own' the behavior rather than blaming someone else. Been there, done that (many times). None of us is perfect. We just need to forgive ourselves, learn from our mistakes and move forward. The OP would fare much better by taking accountabilty for what appears to be a series of omissions - most likely due to time management & prioritization which are skills that all new grads need to develop. If she/he goes into the meeting with a pro-active plan that includes specific corrective actions (e.g. always 'close the loop' when delegating by making sure the task has been done; always check and document IV sites at least two times per shift, etc.), the discussion may have a more positive outcome.

It is very important and very hard to embrace and own up to our weaknesses and recognize what we need to work on and change. However, I do believe that some environments are just toxic and if the nurses there take a disliking to you, you are gone.My first new job out of school I was recruited to an ER that wanted to try training new grads. The nurses there were totally against this and made life hell for the 4 nurses that were recruited. Actually one of the recruits had been a tech there and they were nice to her.When the director had a MI and had to leave all hell broke loose and the 3 of us quit because the nurses just wouldn't work with us.I got a job at a hospital in the next town over on med-surg. When I got there I had no confidence at all. Was sure I was a total screw up. But I had great, caring preceptors and being on that floor, working with that group was a wonderful experience. In time I learned to trust myself and everyone said I was a very good nurse.I made many of the same mistakes this poster is mentioning, but was educated, not whipped. After 2 years I decided I would like to try the ER again so I transferred to the ER. I had a horrible, lazy preceptor that only wanted to talk about her daughters sex life and didn't learn what I should have.I was put on nights and bullied by one nurse so badly that some other nurses actually told on her. The night charge was her best friend and denied that there was any shenanigans. I just kept plodding along because I liked so many of the other nurses, but life was hell. Then she finally got fired for abusing a patient.The job was great and I made it a point to take all the nurses and doctors new to the ER under my wing, and became the official preceptors to many new nurses and paramedics.Eventually I left and started traveling. I have completed 9 travel contracts now and 2 were bad, with charge nurses who were bullies and made my work life horrible. I persevered at one and actually got her demoted from charge. (We now work together at another facility) I have extended all my contracts except one where I was made a DNR because of the charge nurse.I recently accepted a position where I had done agency shifts for several years, but on nights. I was there 5 weeks on day shift and was fired for poor performance. They had a list a mile long of things I did wrong, including supposedly asking someone how to do CPR. I was so stunned I just walked out without questioning anything.Got home and went down the list and studied the ones that I thought might have merit. I talked to nurses I respect and all the points I was worried about were without merit.I had another job in 3 days. I have been there several months now and have no problems what so ever. One of the best nurses I know was told he was too slow and too stupid to be a nurse while he was on orientation. He kept at it and is now a nurse practioner in the ER. There are both positive learning environments and toxic environments.If I were you, I would make an action plan. Work at staying and improving and learning anything you can. Every day you will learn and improve. Keep plugging along knowing that there are many great, supportive work areas out there waiting for you in the future. Learn as much as you can now. And then if you get fired you can go to the next place with the increased knowledge and experience you learned at this place and start fresh.I have many nursing friends who have jumped jobs multiple times, some for getting fired, and some just looking for a "better" place. The economy is bad now, and jobs are hard to find, but this will improve.Make sure you get some references from a couple of people at your current place that do support you before you leave.