1:40 p.m. - 2016-02-10
I got fired ostensibly for trying to cover up a late med. This I did not do. I have 30 patients who have 9 am meds, between one and about 25 of them, often crushed and mixed with applesauce, plus supplements, breathing treatments, eye drops, ear drops, blood sugar checks and insulin coverage. If I were to go by the rule that all meds must be administered an hour before or an hour after the time they are due, I have four minutes per patient to administer them. This is without phone calls (which are frequent), pages from the supervisor, questions from CNAs and PT, and the APRN who wants me to spend 15 minutes looking up a patient's meds on my computer for her -- and not to mention trying to locate, and borrow or restock, meds that a patient should be getting that are not on my cart. Which on certain floors is almost one med per patient.
"One hour before or after" does not happen for me or for any nurse I work with. On a good day, I start my 9 am med pass at 7:15 and I am done by 10:30 (and no one else is). On a not so good day, like the day I got fired, I hit my last patient at 11. And she was missing a narc.
I gave her her other meds and tracked down the supervisor. By facility policy, I can't just borrow another patient's narcotics; I have to get them from the supervisor. The supervisor took an hour, and 3 requests, to actually get me the narc. At this point, I said, since we're here, maybe you could just give me the patient's next dose as well, so we don't have to go through this again in a couple hours.
She said, I'll have to check with the other supervisor. And the next thing I know I am in the office of the director of nursing and she is firing me for allegedly trying to cover up administering a med 3 hours late by double-dosing the patient.
She is correct that the med was three hours late -- I was two hours late (and that is normal for finishing a med pass for every nurse in the facility) when I noticed it was missing, and it took me another hour to get it. I had no intention of double-dosing the patient -- I planned to put her at the end of my next med pass so her narcs would have been three hours apart instead of four as scheduled, but not at the same time. I had no intention of covering anything up. And by putting her at the end of my next med pass I was doing what I had been told to do in similar situations in the past.
Nonetheless, I got canned.
And yes, there is some history here. Ten days earlier, I went to the director of nursing because the same nursing supervisor who accused me of covering up a late med had basically force-fed a comatose patient until she vomited because she was mad at a CNA who said the patient wouldn't eat (and me for standing up for the CNA). I had also been making complaints to several supervisors (and compiling documentation) that nurses were documenting that they had been administering meds to patients that they clearly hadn't, because the meds weren't taken by anyone else in the building, weren't available on the med cart, and had never been ordered from the pharmacy.
It was never my intent to get anyone in trouble with my complaints; I just wanted the patients to get their fucking medication and not be physically abused. But I am thinking that I was probably seen as a trouble-maker. And, of course, that perhaps nursing is not a good career for a former journalist as it is in my nature to try to fix things that are wrong.
Not that I feel OK about it. I feel awful. I feel like it was my fault. I wish I hadn't chosen to do that patient last (I did because she has severe Altzheimers and it takes a very long time to get her to open her mouth, so I wanted to have the time to spend with her). I wish I had discovered the missing med sooner. I wish I were somehow "better" and could administer meds to 30 patients in two hours. I somewhat wish I hadn't run my big mouth, not because it wasn't the right thing to do but because I have two kids with a deadbeat, non-child-support-paying dad and I can't afford to be unemployed.
I feel like I suck, I failed, I let everybody down, no one will ever hire me, and I am terrified.
Getting fired was the first shock of my week last week. The second shock was that when I told my therapist about it, she was outraged -- not at me but at my employer. She wanted the last name of the supervisor in question. I refused to give it up. She said she just wanted to check her out a little bit. I am not sure what she meant by that, but I kind of figure that as long as my former employer is not after my license, I am better off just letting it go.
She says it is not my fault and I got fired because I have principles. This is not how I feel about it -- I feel like I got fired because I suck -- but I know that I didn't do anything dishonest or harmful to a patient, other than working in a place where there are simply too many patients to medicate all of them in a timely manner. But it was nice to have someone believe in me. My therapist is a doctor of psychology and teaches grad students full-time at the state university, but I think the most helpful part of seeing her, for me, is not that she has such a wealth of experience and is very good at what she does, but that she actually LIKES me.
I said, "Maybe I just wasted four years preparing for a career that I'm just not cut out for."
She said, "I don't think that's the case."
So anyway ... she told me she wanted me to call a friend of hers who might have some ideas of where to look for jobs. Her friend is a PhD in nursing and APRN who apparently taught a lot of my nursing school instructors.
Anyhow, I talked to her this morning. Apparently this woman is just a great contact because she knows everyone -- I had heard of her, though never met her. She told me that what happened wasn't my fault, and that she has heard of it happening in nursing homes many times because of the culture of cutting corners -- people who try to fix things are seen as troublemakers and a liability. She said it happened because I have a "strong sense of ethics." She said, "We need to find you a place that is a good fit."
So the upshot is that she promised to get back to me with a list of places where she knows people and she thinks I should apply, and that although it is not exactly "kosher" and she doesn't know me personally, she has great respect for and confidence in Dr. R (my therapist) and "Dr. R speaks very, very highly of you" so she (the PhD. APRN) wants me to use her as a reference when I apply.
In other words, thanks to my therapist, I have this nursing bigwig in my small state offering to help me get a job. Which of course is not-so-indirectly my therapist helping me get a job.
Which is a little weird, and I am sure falls well outside of the traditional boundaries of therapy.
But she has been doing this for 35 years -- therapy -- as well as teaching people how to do it, and I am sure at this point she knows what she is doing. Maybe if I was in her shoes, and I was dealing with someone I knew well and knew wouldn't take advantage, I would do the same thing. Anyhow I appreciate it, maybe more for the expression of faith in me (as a nurse and a person) than anything else. It is certainly nice if your therapist is willing to vouch for you, to her friends, as a good and sane and principled person.
I am not at all counting on any actual help, but my conversation with Dr. Nurse this morning made me feel a little bit better about my prospects of finding a job. I know I will, because I have two kids to support and I don't have much choice, but I feel a little of the "what if I don't?" dread leaving me. All I could think when I got fired was, "Now nobody will want to fire me." Eleven years in news, and I never got fired or even got a performance review that wasn't stellar. I'd never conceived of being fired before nursing. And now ... I had no idea of how to even explain it. But I guess I am starting to.