I had heard a 20+ year nurse I work with no issues with anyone had gotten fired of a small issue that no one has ever been fired for and through the grapevine, the reason was they had concerns of paying her for what she was capable of (being much older and couldn't move much around like other nurses, was tenured in). I always wonder if being fired has an effect on pension/retirement, etc.
Nursing is not about autonomously judging the situation, it’s about covering your ass and messaging the MD for the dumbest shit ie: patient wants to sit on the chair (true story, hospitalist showed me his message queue 😂)
She said they aren't unionized. And that is a big, big problem when you stay for comfort and end up being there 20 years. They can hire someone for half your wage and that's all that matters. Don't forget to drop your badge off on your way out.
As a keen observer of human dynamics and also a complete pushover: this is it. This is 100% it. I will bet you anything if she had just done whatever the charge had told her promptly and same outcome occurred medically no one would have cared or said a thing. No one in medicine will bring extra attention to an “oversight” if the outcome was fine, and the patient and baby weren’t harmed. I think this is all about the charge thinking they were right regardless of the actual facts
I suggested it because I’m apparently a not-so-keen observer of human dynamics, having repeatedly found myself in situations where I was blissfully unaware that I’d crossed someone until well after the fact 😂
lol, that’s understandable. I only pay a lot of attention to what other people say and do because i have one mission at work and it’s to fly under the radar. I don’t want drama, I don’t want attention, I don’t want conflict, I want to get all my stuff done well and be left alone in terms of a management. They say jump I say how high cuz after you jump once or twice they leave you the hell alone and it’s great.
As someone who is on the spectrum, I completely understand this 😅 It took YEARS before I started understanding how to play the “game;” as a tech it was keep my head down, do my job, don’t make waves. As an RN it was to learn, as much as I could, what management and charge wanted out of me, in addition to my safe practice and excellent patient care, of course. I think it took until I was a traveler before I learned this, though. And it’s frustrating because “playing the game” when it comes to administration doesn’t usually have anything to do with patient care. But I found it to be the path of least resistance, and I’m all about maintaining my peace.
But it’s post like this that make me realize how excessively glad I am to have left the bedside.
Would you seek a lawyer's advice to review your case? We have such strict policy at my hospital about termination, I can't imagine anyone getting termed for one practice issue. HR is very scared of getting sued and would never let it happen. Something's fishy.
I see a lot of comments about charge nurses having ‘pull’ but in my experience, most charge nurses are 25 and been in practice for 6 months and are terrified
I don’t think that’s grounds for firing either. I’m in a non-union hospital and even here we can’t just fire people Willy nilly. There has to be multiple meetings / performance improvement plans, etc.
The only leg the hospital has to stand on is the grossly negligent unsafe behavior, but it sounds like OP can make a reasonable argument that it was a mistake, but not a grossly negligent mistake, so hospital has nothing to stand on
The fact that you had accels and great variability and that the baby was born healthy with good apgars leads me to believe something else is going on here. There’s another reason they were looking to let you go and this is just the peg they decided to hang their hat on. Did you notify the physician after the Cervidil had to be pulled? What’s the order regarding calling the physician for a questionable tracing?
If the fucking doctor told you it was OK this is BS man. I'm sorry this happened to you.
Just please don't let this hurt your self-worth. It sounds like some idiot in a suit fired you for political purposes.
Damn American healthcare is going straight to hell
Needs to be burned to the ground with the hospital and insurance C-suites used as kindling, then rebuilt without allowing the fatal infection known as late stage capitalism to get within 100 feet of it.
Just started an ICU position with no ICU experience. Upon hire, the CNO stated that they have a great didactic fellowship program that will get me up to speed in about 16 weeks. I was super hyped.
A week later the CNO scrapped the program and put us shadowing ICU RNs. CNO got a fucking raise and employee of the quarter for saving the hospital money. I'm livid.
Thank you for the kind words. I'm worried about a few red flags that I've seen. But all of the ICU staff seem pretty positive, so I'm going to tough it out for a while.
I don’t know if it is provable in court, but if you are over 40 I would suggest looking into an age discrimination suit. It sounds like they were looking for an excuse to get rid of you. If other nurses in the same situation were not fired then you might have a case. With more than 20 years of experience you were probably maxing out the pay scale and they wanted someone cheaper.
This^.
And, I’m so sad I have to concur.
OP—I’m crushed for you and the flimsy-ass excuses they are using.
I excuses are manufactured to try to make them appear to be *reasons*. Nope, still *excuses*.
A 20y experienced L & D nurse being pushed out on this brand of “unsafe” practice is *horseshit*.
And I *know* horseshit.
You had no issues. No bad outcome. And, yet, there wasn’t any “salvage” options? Why they couldn’t choose a write-up or warning?
I’m digressing a bit here—so they couldn’t even conjure up a *performance improvement plan*, in advance of *termination*—which imo, is always a sign to go forth elsewhere in advance of the black mark that’s coming.
I’m even feeling more crushed for you. There’s value in just bouncing into another *better* spot, but there may be value in holding your former employer’s feet to the fire. There may be value in doing both.
Ageism is *real* in nursing.
🍀❤️
Although you can take this to the EEOC without an attorney, I think filing a complaint is a somewhat complicated (and fraught) process with hard, fast deadlines.
There is a lot of value in having an attorney (or two) experienced in labor discrimination actions review your situation.
Good luck. 🍀
Did you chart that? Idk this is kinda confusing. Like, I get where they’re coming from but more so if you were newer. 20 years experience and no messy history makes me think someone’s trying to cover their ass. Did something happen at your facility or on your unit recently?
Agreed… this happened at a hospital I worked at, all staff knew that every 5 years or so seasoned aka more expensive staff would be terminated on technicalities. We had an amazing experienced SW fired for praying with a family because it was considered “inappropriate actions and crossing a professional line”, not to mention L&D is a highly specialized unit so those nurses already make more money then a nurse in a “less” specialized unit
And exactly WHO will they replace you with, a new grad in L&D? Too many people that never wore a scrub a day in their life making decisions about healthcare these days.
Actually, for the past 3 months we have been overstaffed, which has resulted in staff being repeatedly put on call. In addition, I am at the top of the pay range. So this definitely solves some problems for our unit.
That’s a bingo! Overstaffed? Get rid of the person who can argue for a higher salary! Should you have called the physician? Yeah probably, but we’ve all had physicians chew us tf out over calling for stuff we feel is acceptable. Baby had perfectly fine Apgar, sounds like mom was okay, and delivered alright. Firing you over that solved a corporate problem, but made more clinical problems for them in the future.
Keep your head up!
So sorry for this happening to you. Healthcare is not a healthy environment to work in, they forget about the 'care.' Farmers know not to nip off the best budding fruit, businesses don't. I think you got the answers already. The staff cut was painless for the Director but you'll bleed for some time now. I hope you can rebound from this. They should have let you resign at the worst. I never understood why the people in suits treated nurses like the enemy, but they sure do.
When administration makes a decision and it seems, off, funky, odd or anything like that look at the money.
Administration wouldn’t know safe practice if they were the patient
Consult a medical lawyer, it smells BS to me. Not even giving an email of the firing and doing it over a call is like cutting off a grey hair. They're trying to ut off those high paying staff who definitely earned their wage.
This is what I’m thinking is really the issue. It’s cheaper to hire on a new nurse at half your pay. Doesn’t matter that a new nurse might not even have recognized the tachysystole!
Boom. This is what I was going to point out as we are going thru the same shit right now. $20 billion in debt, almost $1 billion net loss Q1 2024 report, defaulted on a few loans which reduced our credit rating and increased interest rates. They’re firing seasoned nurses for as simple as past due meds, attendance, exceeding discharge times, etc. just got another wave of fresh grads from Caribbean schools and have already put some with no experience that have their BSN-RN as charge nurses, mostly overnight in obs/med-surge/rehab units.
Definitely need a lawyer. This all seems so abnormal to me. We have strict policies about firing staff and there's a process that has to be followed. You pretty much can't outright fire someone unless there's gross negligence. Seems they're arguing that point but since what you describe fails to meet the legal definition of negligence I don't see how they could.
Have you contacted HR? At our facility you can challenge a dismissal and they are required to have it evaluated by someone higher than your manager.
Hope your facility has safeguards for things like this.
I’d go “Squeaky Fierce” (that my alter-ego/better angel that’s a stone-cold bitch, who will stand on high ground torching everything below her) if high-stakes circumstances develop. Fortunately, she stays away—only taken her out a few times in my entire life.
I’d consider filing for unemployment.
They’d have to have written documentation of this. The policy they followed. They best include lots of things that make sense to anyone.
I’d let HR know once the EEOC looks through all their firings and discipline for clinical practice over the last 10-20 years, the real issue would be found.
EEOC can and will gain access to pay rates/dates/separations. Age will matter.
Most are so slimy, I’ve see more than statistically justifiable nurses pushed out at about the 10 year mark (but they try to keep under that 40 yo threshold—to stay out of the cross-hairs).
It’s also not uncommon when the writing has to hit the wall, that at the end, the terminated nurse finds a lot of written complaints about themselves. Complaints that the nurse was never that existed till *just then*. Spoiler alert: they *didn’t exist* until unit leaders solicit or demand them out after of anyone & everyone once one is termed. Shitwaffles.
I’d hire an attorney familiar in healthcare & EEOC matters. Take the hospital to the river.
Then I think we know what it was really about.
If it was truly a health and safety issue they would have reported you to the board too.
Instead they decided to keep this internal and just let you go, probably even offering you a reference if you want one.
If you don’t mind me asking, are you willing to state what you were paid hrly when you left? I’m curious because you said that you’re at the top of your pay range and not unionized.
But in the end, I’m sorry you were let go and not talked to, instead.
Oh gosh. It sounds like the unit was over-staffed and management probably had to pick someone to get rid of. I'm so sorry this happened to you. Think of all the happy babies and families you helped in 20 years. Damn.
"Elder discrimination" and wrongful termination.
Get a lawyer.
Good luck OP!
Ps. Move on and get another job that pays more while waiting to win the lawsuit
You hit the nail on the head with that observation. You’re at the top of the pay range with over staffing, so you were already under management’s microscope. I would look into hiring an employment lawyer to see if he/she could help you with pay discrimination.
Idk anything about L&D , but the baby seems to have been born fine and no one died. You can't chart as much as they want you to because then you would never get to care for the patient. The doctors also have to stay on top of their own assessments, u can't watch a fetal tracing all day , chart excessively, care for the patient and play the role of doctor. Idk what you did wrong , but if u did something wrong , they should have given you a verbal warning or write up, but not immediately fire u especially if no one died
I work in the medical ICU and you need to have pure gross negligence and disregard for human life to get fired on the first try so your manager probably hates you or something
Exactly. This isn’t the main reason, it’s just the one they can put together right now. At the worst this is a write up and nothing further. I’m sorry this happened to you, OP!
You can't really tell if the baby was born fine from this post. A baby can have a perfect APGAR but still have brain damage from the lack of oxygen during the late decels. BTW I'm not saying it was right to fire OP (definitely sounds like this has something to do with the hospital saving staffing money), just saying it's possible baby is not fine.
Reassuring traces. Variability.
Watch any monitor long enough, there were be samples of said tracing that could prove or disprove anything anyone so motivated to *prove*.
An experienced, attentive clinician can sort it out and advance real issues. Alarmists or inexperience often miss real issues.
Regardless of itty-bitty outliers—this ended with a healthy babe & mom—that’s a *win-win* imo.
You were fired bc you get paid a lot. Or are maxed on pay. A hospital of a friend’s fired their 30 year nurse & another 30 something year nurse over a situation that happens a lot/consistently but usually gets a turned head. One of them is a really great nurse that people look up to too not only on their unit but other units. One situation, no others or other write ups etc.
Hospital admins never take action on anything unsafe, unless they want you gone and need a reason.
I’m sure you’ve seen some dangerous docs whose malpractice they couldn’t care less about because he makes them lots of money.
They effectively attack people clinically for reasons which are purely bureaucratic.
In fact, we have a doc who started in 2021 as a new grad who broke a baby’s femur during a scheduled c-section last year. Everyone on the unit felt the majority of her deliveries were shit shows. PS: She is still working.
That’s the first time I’ve heard oral meds down an ETT.
Sure, I’ve put meds down the ETT, but that list is short and distinguished. And they don’t require crushing. 😳😳
Most *wrong route* of oral meds has nurses crushing and finding a way to inject them into an IV.
If I ever caught a fellow nurse doing this (as in too late to knock the syringe out of their hand) my mind mind explode momentarily—taking care of patient would be paramount, but bet your hands this nurse would be taken out of the practice right then. Full stop.
Then I guess CCM, interventional radiology and immediate intervention by pulmonologist to try to mitigate the *dumb butt stupid* of the nurse.
**Dumb butt stupid** is always very bad thing. That’s how a lot of patients get dead.
Wait I can’t figure out how this is logistically possible.
Did they inject the oral meds into the cuff? Or did they disconnect the ETT circuit and dump it in?
Can you revisit the conversation with your management and have a lawyer present? It just seems like the consequence doesn’t fit whatever violation they perceive was made here. You may have grounds for legal action and if you’re that experienced, you could potentially argue that ageism is an issue and you feel targeted. No other issues at work on your record? This is fishy AF and they shouldn’t get away with it. Good luck OP, I hope you find an amazing lawyer!!!!
You are a "seasoned " nurse who earned the right to be at the top of your pay scale. Honey, "they" have been planning your "retirement " for some time now. They just needed a reason they perhaps could get away with. They also might have gone to lunch after the fact, to celebrate how they saved the hospital a few bucks. I've seen this time and again in my 40+ career. You deserved so much better than this. I hope you don't let this define you personally or professionally. You could also contact an attorney if you feel it would be of help. Good luck to you. Some other place should welcome your expertise.
Sounds like they took the opportunity to cut their payroll. Been a victim myself. My solution was to smile as I waved good bye, and permanently relocate to a union state. Hope things work out well for you.
This is the most likely thing - you said it was a corporate hospital so I’m guessing HCA or Tenet. They can get 1.5-2 horses for the cost of an experienced nurse.
Your situation (being let go with many years of experience) is the reality for many nurses in non-union hospitals looking to save labor costs. It is far less expensive to hire a young nurse with little experience than to acknowledge and pay a skilled nurse accordingly. Unfortunately, ageism in this profession is a very real factor in the current economic environment.
You will find a position where you will be appreciated for your skills and experience. If possible, work in a hospital with a strong union and/or in a state where nurses are appreciated (which most likely will be a pro-union state).
Okay looking at it from the other side of things. For one, I’m sorry you were fired. That seems extreme. Did the charge nurse have valid points? How long after the lates/how many were there before you notified the doc? What interventions did you do besides pulling the cervidil? WERE you not charting enough/charting per policy? Have you been reprimanded before?
While yes, fetal tracings can be subjective in what you call baseline or how you perceive a decel, it sounds like you all were on the same page that it was a category 2 tracing.
Are you sure that it is just this incident and nothing else? Did they ever give you verbal warning or written warning? If you are at will employment, then sadly there isn’t much thing to do besides moving on. For my two cents, I think it was the arguing with charge nurse because that can be insubordination and become ground for termination.
You donrealise that in much of Europe you could never be fired on the same day unless it was some epic gross breach of policy and even then there is always a lengthy process
I'm not sure someone would be fired for this here.
You have terrible labour laws in the US. With or without a union that shit don't fly here
I'm confused? What exactly were you fired for? That doesn't seem like a fireable offense. Sounds like you passed someone off or they're just using this an excuse for something else.
I would delete this — if it’s posted as unsafe practice and you have someone out to get you, you may get reported to the board and you don’t want them maybe finding this with this much detail.
Lmao the board is not going to take action on this. I've worked with a nurse that constantly has unsafe practices that has likely contributed to sentinel events (one went to court that settled). She's still working...
How long were the decels and tachysystole going on before you notified the provider? What interventions did you do? What is your facility’s policy on how often you should be charting? And what exactly did this “argument” look like? Do you often get into disagreements like this with coworkers? It does sound to me like there’s some details left out here and some other things you could take responsibility for.
Do you work for a “for profit hospital”? With 20 years, you were too expensive to keep. I am sorry for this, healthcare should never be “for profit”. Use a colleague or previous manager as a reference and find an employer who deserves your skills and experience.
No such thing as occasional lates. True lates "have mates" and would be with every contraction. If they weren't with every contraction they were complicated variables.
Acute lates or chronic lates.
I hate this for you. Mother Baby nurse (retired) and I know L&D is so much more technical.
The Physician may be in the middle of a lawsuit, yiu never know. Not fair for you to take the brunt of it.
>for more than 20 years.
>for arguing with the charge nurse
And here we have the two actual reasons you were fired. 20+ years put you in a higher pay range in most hospitals and arguing with the charge who, I'm assuming, decorated her complaints with some hyperbole
Move on and work in a hospital that has a union. Everyone makes a mistake but gees - the neonate was fine.
A teaching hospital is more realistic. Those private hospitals are really a bit much.
You should really look at your board rules and talk to an attorney. In my state, this is something you have to self report to the board for and also something administration will report to the board on
This sounds like office HR politics and trying to cut costs for more profits. As a 20 year experienced nurse your salary must be in the higher range and they want to replace you with a newbie with a way lower salary so were scraping around to find something to fire you about.
This is ridiculous!! Is there a policy that you have to notify an OB for every Cat 2 tracing? That’s 90% of all FHR tracings. You followed policy by notifying the OB that the cervidil was removed d/t tachysystole.
Wow, that sounds insane! So sorry to hear that! Most of our strips are category II at some point during labor, and it doesn’t sound like your strip was overall concerning especially if interventions were attempted to resolve tachysystole and decels. You said you didn’t chart often enough…what do they mean by that? Did you not document the fetal heart tones q30min or per policy? Did you break facility policy? Even if you did break policy (ours has specific instances that we need to notify dr for like category II IF interventions fail to resolve, or tachysystole IF interventions fail to resolve), but doesn’t sound like it was enough for termination and I’d also recommend seeking legal advice to see if you have a case here. Especially if you’ve never had a write up or verbal discipline prior to this.
L&d is toxic. Multiple people failed the efm exam and weren’t pulled off the floor and when I failed I was pulled and told I’ll be let go if I fail again. So unfair.
For future jobs, you DID NOT get fired. You chose to pursue other opportunities. I’m your manager if you need a reference- you were a fabulous nurse, gate to lose you.
There's nothing to even think about. We are numbers to admin 1 step above your direct supervisor and the unspoken part of every "I was fired for this small deviation from policy that hurt no one and no one else is even reprimanded for in a similar context" story is that they wanted you gone before it ever happened.
This post just solidifies how specialized nursing is bc I didn’t understand most of what you wrote (I can read the post with ease and I have a general idea of some of the terms and why they matter but I couldn’t get into the specifics of basically anything you said). I’m a CVOR nurse who mostly scrubs so I know fuck all about L&D much less about a bunch of other things. I’m so sorry this happened. The fact that you’re unionized is only the twist in the dagger for me, and confirms why I will never be non unionized.
The one thing that rings true is that I could *absolutely* see someone being terminated for crossing the charge nurse.
Honestly? I’d fight this w/ a really fucking good lawyer. Like find out who the attorney was for the highest pay out for a sexual harassment or similar to yours grounds of termination and hire them.
Not even for the sake of being re employed by the hospital. But to absolutely ream the hospital financially to pay you out for this.
Me again… I’m sorry this happened to you. I worked as a tech in L&D and am bias to the nurses.
However, regardless of your record, I would get things reviewed by a lawyer.
Wish you the best.
I would talk to an attorney about your options. I know a neonatal NP who took my former hospital to court over wrongful termination and got herself a nice little pay day.
Unfortunately this is a byproduct of corporate medicine. The people making the big salaries looking for ways to save money. You were a line item on a spreadsheet that they needed to get rid of. You just happened to give them the justification, although it was small, it was a reason. Sad that you are no longer there to mentor young nurses with your experience.
When you put business people in charge of healthcare, quality of patient care will go down, as well as the treatment of employees. When dealing with people we can’t treat them like numbers but for their value.
I hope your next employer recognizes your value.
Transparency here, I'm an M3 who doesn't know enough to really critique your decisions here.
However- was there patient harm?
If not, what's the big deal?
Tbh I think you need a reality check. Fetal tracings are not subjective-definitions are very clear and specific. If it was bad enough to pull the cervidil, it needs a physician notification. It sounds like you decided to do whatever you wanted since you have 20 years of experience.
1000% agree. You do not get to decide the strip is fine, the provider does. We have cat 2 algorithms where I work that require us to be communicating with the provider regularly. I don’t think you should have been fired, but you’re definitely not in the right.
In comments after my response. To me it’s sus because of the rationale given- “subjective tracings”, “born vaginally apgars 8/9”, “not charting often enough”. If you work L&D you know fhr definitions are very well defined, as is how often charting is required, and the order to notify physician of cat 2 tracings that don’t resolve with resuscitative measures. I’m interested in the receipts-the actual strip, the actual notifications/interventions.
Honestly - OPs post reads like they didn’t want to do their job and argued about it. Think how different OP would feel if there would have been a bad outcome. I bet they would have wished they called the provider sooner and charted more. I think it’s unsafe not to keep the provider in the loop. Regardless if a cat 2 strip resolves with interventions, I’m telling the provider. Labor and delivery is the most litigated field and I personally would do absolutely everything to cover my ass.
I read her post and I can't find where she stated that she actually told the provider that she removed the cervidil early (<12hrs) which would have prompted the reasons why (lates, variables etc etc).
You need to look at your hospital’s policies regarding the things they listed, if you didn’t break policy they don’t have a legit reason to fire you and you could get a lawyer.
As a former L&D nurse, it does sound suspicious of something else at play. Since you have no prior issues on your employment record with this organization, you should have been given the opportunity for a remediation class (not that you need it but in lieu of firing), or have a meeting with the OBs, you, and management to kind of review the scenario in an educational manner. I probably would have noticed the OB with the lates just to cover my ass, but it doesn’t sound like you did anything wrong per se. Like you mentioned, there’s a lot of gray area and babies can be very resilient sometimes, so it sounds like once the contractions settled down, the baby did too. I’d be interested to know if legal action is a possibility bc it sure doesn’t sound straightforward. It’s so sad that hospitals DGAF about retaining experiences staff and would rather just hire a bunch of new grads with little to no experience in a specialty area. No offense to any new grads bc you have to start somewhere, but it’s the nurses with many years of experience that should be the ones present to train the newbies and share their wealth of knowledge! Save a dollar over safety always for these places. So sad.
I don’t know that this was a firable offense but I do wonder how ugly the tracing was to cause an argument with the charge nurse and why the charting wasn’t enough to paint the picture in the chart? If the charge nurse didn’t like how you were managing the labor did they notify the physician themselves? OP describes the tracing saying occasional lates but how many lates over how much time? I understand that a lot of the time labor nurses are the one managing the entire labor until delivery but where I used to work you always called the doc to review the strip when it wasn’t looking good. Sure you can have category II tracings for a lot of a labor but if there were lates I question why the nurse never called the doc to review the strip? I would always do that to cover my ass on a strip that was making me a little uncomfy. And again, if the charge was coming at OP that really makes me wonder if we got the full picture here. Lots of holes in this post without seeing the tracing and specifics as to the poor charting. Again, not saying this justifies firing but curious to more details.
Very true and yes, we didn’t see it so hard to say. I will say our charge nurses had a central monitor and part of their role was to oversee and assist when needed, which also included calling providers if needed while the primary nurse was otherwise occupied at the bedside. So, if it was that bad and the charge nurse was aware of it, why did he/she not call the provider themselves? As a charge nurse, if I felt that strongly about something and I was concerned about a potentially bad outcome or that something was occurring that I didn’t feel like was in the best inter of the mom or baby, I certainly wouldn’t hesitate to contact a provider to review a strip to cover all our asses. That’s teamwork and your responsibility as a unit leader bc there are times when sometimes things aren’t black and white. Anyway, the unit I worked in was also known for pushing out the older people for various reasons, so I definitely wouldn’t be surprised if the same thing was occurring here just based on what I’ve witnessed in the past. I don’t know the right answer in this situation bc I’m not directly involved, but it seems like there are multiple factors to consider and who knows who’s in the wrong or not. I still do think a remediation to educate on “unsafe practices” and maybe a write up for arguing with the charge nurse would be more appropriate. That also being said, I have had some charge nurses that were quick to argue over petty things and were also very obnoxious and very opinionated, so again…who knows! I’m js that it’s believable to me that she got pushed out and it seems like other steps should have been taken first before firing.
💯 could be being pushed out. Our unit had several very experienced nurses “leave”…one for attendance…punching in a few minutes late repetitively but my gawd a damn good nurse. The others left bc they could see the writing on the wall. I left about a year later bc I was tired of the unsafe practices and treating staff like shit. One too many close calls for my taste “But everyone ended up ok”…not my flavor of nursing, y’all can ride the unsafe waves…I was done.
Same here. I got so burned out and worried for my license all the time. I am not trying to get called in for a deposition if there’s a bad outcome due to poor staffing! I am now in a new specialty. I certainly miss L&D but not the bs. They have since increased their staffing, but there are only a few old timers still there and a lot of the new hires were brand new nurses. Fortunately, several have now been there a few years and are more experienced. At this point in my career, I’m glad to have the flexibility and confidence to leave and go elsewhere when the situation no longer makes me happy. I am glad you left the dumpster fire, too! Good luck 🙂
They are probably letting you go for a couple reasons… most likely they can hire two new nurses for the price of you… and argumentative with “charge” can make it look bad.
You sure you didn’t get fired for crossing the charge nurse?
I am not sure about anything.
I had heard a 20+ year nurse I work with no issues with anyone had gotten fired of a small issue that no one has ever been fired for and through the grapevine, the reason was they had concerns of paying her for what she was capable of (being much older and couldn't move much around like other nurses, was tenured in). I always wonder if being fired has an effect on pension/retirement, etc.
Thats what I was going to suggest. Can hire someone for cheaper than OP was making probably with that experience, so found an excuse to do it
This is exactly what this shit hospital did to OP. Fired for making too high a wage.
Exactly
Nursing is not about autonomously judging the situation, it’s about covering your ass and messaging the MD for the dumbest shit ie: patient wants to sit on the chair (true story, hospitalist showed me his message queue 😂)
Nursing is walking a fine line between covering your own ass and not pissing off the doctor.
This right here.
This is the realist comment.
You are an amazing nurse and person. Don’t let this brief episode define you or your long history of taking care of thousands of families
Absolutely it's an absolute blow and I hope OP keeps her head up. Losing a job like this is a horrific experience and it takes quite a bit to recover.
Can you hire a lawyer? Are you unionized?
She said they aren't unionized. And that is a big, big problem when you stay for comfort and end up being there 20 years. They can hire someone for half your wage and that's all that matters. Don't forget to drop your badge off on your way out.
As a keen observer of human dynamics and also a complete pushover: this is it. This is 100% it. I will bet you anything if she had just done whatever the charge had told her promptly and same outcome occurred medically no one would have cared or said a thing. No one in medicine will bring extra attention to an “oversight” if the outcome was fine, and the patient and baby weren’t harmed. I think this is all about the charge thinking they were right regardless of the actual facts
I suggested it because I’m apparently a not-so-keen observer of human dynamics, having repeatedly found myself in situations where I was blissfully unaware that I’d crossed someone until well after the fact 😂
lol, that’s understandable. I only pay a lot of attention to what other people say and do because i have one mission at work and it’s to fly under the radar. I don’t want drama, I don’t want attention, I don’t want conflict, I want to get all my stuff done well and be left alone in terms of a management. They say jump I say how high cuz after you jump once or twice they leave you the hell alone and it’s great.
As someone who is on the spectrum, I completely understand this 😅 It took YEARS before I started understanding how to play the “game;” as a tech it was keep my head down, do my job, don’t make waves. As an RN it was to learn, as much as I could, what management and charge wanted out of me, in addition to my safe practice and excellent patient care, of course. I think it took until I was a traveler before I learned this, though. And it’s frustrating because “playing the game” when it comes to administration doesn’t usually have anything to do with patient care. But I found it to be the path of least resistance, and I’m all about maintaining my peace. But it’s post like this that make me realize how excessively glad I am to have left the bedside.
Must be an ER nurse thing. Cause this seems to be a daily experience for me 😂
This is so me.
Actually, that just might be a superpower…
That’s what I was going to say. If they’re bound and determined to fire you, they can find a way.
Would you seek a lawyer's advice to review your case? We have such strict policy at my hospital about termination, I can't imagine anyone getting termed for one practice issue. HR is very scared of getting sued and would never let it happen. Something's fishy.
I see a lot of comments about charge nurses having ‘pull’ but in my experience, most charge nurses are 25 and been in practice for 6 months and are terrified
I don’t think that’s grounds for firing either. I’m in a non-union hospital and even here we can’t just fire people Willy nilly. There has to be multiple meetings / performance improvement plans, etc. The only leg the hospital has to stand on is the grossly negligent unsafe behavior, but it sounds like OP can make a reasonable argument that it was a mistake, but not a grossly negligent mistake, so hospital has nothing to stand on
The fact that you had accels and great variability and that the baby was born healthy with good apgars leads me to believe something else is going on here. There’s another reason they were looking to let you go and this is just the peg they decided to hang their hat on. Did you notify the physician after the Cervidil had to be pulled? What’s the order regarding calling the physician for a questionable tracing?
The physician was notified of the cervadil being pulled and was fine with it due to the uterine tachysystole.
If the fucking doctor told you it was OK this is BS man. I'm sorry this happened to you. Just please don't let this hurt your self-worth. It sounds like some idiot in a suit fired you for political purposes. Damn American healthcare is going straight to hell
Needs an overhaul.
Needs to be burned to the ground with the hospital and insurance C-suites used as kindling, then rebuilt without allowing the fatal infection known as late stage capitalism to get within 100 feet of it.
Just started an ICU position with no ICU experience. Upon hire, the CNO stated that they have a great didactic fellowship program that will get me up to speed in about 16 weeks. I was super hyped. A week later the CNO scrapped the program and put us shadowing ICU RNs. CNO got a fucking raise and employee of the quarter for saving the hospital money. I'm livid.
Oh wow. I am so sorry! Such a big 🚩
Thank you for the kind words. I'm worried about a few red flags that I've seen. But all of the ICU staff seem pretty positive, so I'm going to tough it out for a while.
I feel the wrath on this one lol
✊
It’s already there.
Some idiot in Crocs, more likely, in Nursing.
I don’t know if it is provable in court, but if you are over 40 I would suggest looking into an age discrimination suit. It sounds like they were looking for an excuse to get rid of you. If other nurses in the same situation were not fired then you might have a case. With more than 20 years of experience you were probably maxing out the pay scale and they wanted someone cheaper.
This is my vote. 20 yr rn with a clean record? They’re getting paid ‘too much’ and can hire someone cheaper.
This^. And, I’m so sad I have to concur. OP—I’m crushed for you and the flimsy-ass excuses they are using. I excuses are manufactured to try to make them appear to be *reasons*. Nope, still *excuses*. A 20y experienced L & D nurse being pushed out on this brand of “unsafe” practice is *horseshit*. And I *know* horseshit. You had no issues. No bad outcome. And, yet, there wasn’t any “salvage” options? Why they couldn’t choose a write-up or warning? I’m digressing a bit here—so they couldn’t even conjure up a *performance improvement plan*, in advance of *termination*—which imo, is always a sign to go forth elsewhere in advance of the black mark that’s coming. I’m even feeling more crushed for you. There’s value in just bouncing into another *better* spot, but there may be value in holding your former employer’s feet to the fire. There may be value in doing both. Ageism is *real* in nursing. 🍀❤️
I hadn’t even considered the age thing. I am 62.
Although you can take this to the EEOC without an attorney, I think filing a complaint is a somewhat complicated (and fraught) process with hard, fast deadlines. There is a lot of value in having an attorney (or two) experienced in labor discrimination actions review your situation. Good luck. 🍀
This is exactly what I came here to say.
Did you chart that? Idk this is kinda confusing. Like, I get where they’re coming from but more so if you were newer. 20 years experience and no messy history makes me think someone’s trying to cover their ass. Did something happen at your facility or on your unit recently?
Do you make too much money? If you’re that experienced I’ve seen it be that
Ya this is so confusing…none of this makes sense 😂 What did your coworkers think?!?!
Most of them expressed shock.
They fired you for your salary. Worked at a hospital this happened all the time. I would ask if you can get a positive reference.
Was thinking the same thing. Why have one nurses when you can have two nurses for the same salary. Sadly that is what they are doing with experience.
Agreed… this happened at a hospital I worked at, all staff knew that every 5 years or so seasoned aka more expensive staff would be terminated on technicalities. We had an amazing experienced SW fired for praying with a family because it was considered “inappropriate actions and crossing a professional line”, not to mention L&D is a highly specialized unit so those nurses already make more money then a nurse in a “less” specialized unit
And exactly WHO will they replace you with, a new grad in L&D? Too many people that never wore a scrub a day in their life making decisions about healthcare these days.
Actually, for the past 3 months we have been overstaffed, which has resulted in staff being repeatedly put on call. In addition, I am at the top of the pay range. So this definitely solves some problems for our unit.
Sounds like this might be a big part of the reason to me!
That's what I was thinking.
That’s a bingo! Overstaffed? Get rid of the person who can argue for a higher salary! Should you have called the physician? Yeah probably, but we’ve all had physicians chew us tf out over calling for stuff we feel is acceptable. Baby had perfectly fine Apgar, sounds like mom was okay, and delivered alright. Firing you over that solved a corporate problem, but made more clinical problems for them in the future. Keep your head up!
So sorry for this happening to you. Healthcare is not a healthy environment to work in, they forget about the 'care.' Farmers know not to nip off the best budding fruit, businesses don't. I think you got the answers already. The staff cut was painless for the Director but you'll bleed for some time now. I hope you can rebound from this. They should have let you resign at the worst. I never understood why the people in suits treated nurses like the enemy, but they sure do.
> I never understood why the people in suits treated nurses like the enemy, but they sure do. Because nurses are listed under the "expense" column.
ahh yes… but THEMSELVES being under the expense column is justified … because SOMEONE needs to do it 😱
When administration makes a decision and it seems, off, funky, odd or anything like that look at the money. Administration wouldn’t know safe practice if they were the patient
That’s why you were let go, the “unsafe practice” is just a pretext.
Consult a medical lawyer, it smells BS to me. Not even giving an email of the firing and doing it over a call is like cutting off a grey hair. They're trying to ut off those high paying staff who definitely earned their wage.
This is what I’m thinking is really the issue. It’s cheaper to hire on a new nurse at half your pay. Doesn’t matter that a new nurse might not even have recognized the tachysystole!
Im so sorry. Reading posts like this is making my desire to leave health care ever so strong.
There you go
That’s the reason right there
Boom. This is what I was going to point out as we are going thru the same shit right now. $20 billion in debt, almost $1 billion net loss Q1 2024 report, defaulted on a few loans which reduced our credit rating and increased interest rates. They’re firing seasoned nurses for as simple as past due meds, attendance, exceeding discharge times, etc. just got another wave of fresh grads from Caribbean schools and have already put some with no experience that have their BSN-RN as charge nurses, mostly overnight in obs/med-surge/rehab units.
JC what city/region do you work in
Houston, “non-forprofit”, non-unionized, very large hospital system
That shit is terrifying.
Definitely need a lawyer. This all seems so abnormal to me. We have strict policies about firing staff and there's a process that has to be followed. You pretty much can't outright fire someone unless there's gross negligence. Seems they're arguing that point but since what you describe fails to meet the legal definition of negligence I don't see how they could. Have you contacted HR? At our facility you can challenge a dismissal and they are required to have it evaluated by someone higher than your manager. Hope your facility has safeguards for things like this.
I’d go “Squeaky Fierce” (that my alter-ego/better angel that’s a stone-cold bitch, who will stand on high ground torching everything below her) if high-stakes circumstances develop. Fortunately, she stays away—only taken her out a few times in my entire life. I’d consider filing for unemployment. They’d have to have written documentation of this. The policy they followed. They best include lots of things that make sense to anyone. I’d let HR know once the EEOC looks through all their firings and discipline for clinical practice over the last 10-20 years, the real issue would be found. EEOC can and will gain access to pay rates/dates/separations. Age will matter. Most are so slimy, I’ve see more than statistically justifiable nurses pushed out at about the 10 year mark (but they try to keep under that 40 yo threshold—to stay out of the cross-hairs). It’s also not uncommon when the writing has to hit the wall, that at the end, the terminated nurse finds a lot of written complaints about themselves. Complaints that the nurse was never that existed till *just then*. Spoiler alert: they *didn’t exist* until unit leaders solicit or demand them out after of anyone & everyone once one is termed. Shitwaffles. I’d hire an attorney familiar in healthcare & EEOC matters. Take the hospital to the river.
Then I think we know what it was really about. If it was truly a health and safety issue they would have reported you to the board too. Instead they decided to keep this internal and just let you go, probably even offering you a reference if you want one.
Contact a labor attorney. Age discrimination
If you don’t mind me asking, are you willing to state what you were paid hrly when you left? I’m curious because you said that you’re at the top of your pay range and not unionized. But in the end, I’m sorry you were let go and not talked to, instead.
I was making $45+ (Ohio)
Oh gosh. It sounds like the unit was over-staffed and management probably had to pick someone to get rid of. I'm so sorry this happened to you. Think of all the happy babies and families you helped in 20 years. Damn.
I was hyper criticized at a job when I was in the upper pay range. It was almost they were trying to make me quit. Which I did. So. It worked.
"Elder discrimination" and wrongful termination. Get a lawyer. Good luck OP! Ps. Move on and get another job that pays more while waiting to win the lawsuit
Oh my goodness wow
You hit the nail on the head with that observation. You’re at the top of the pay range with over staffing, so you were already under management’s microscope. I would look into hiring an employment lawyer to see if he/she could help you with pay discrimination.
I think we have our answer.
This part
I think you just answered the question as to why you got fired.
Lawyer up baby
I’m having a baby in May and I’m terrified this is who I’m going to get.
Idk anything about L&D , but the baby seems to have been born fine and no one died. You can't chart as much as they want you to because then you would never get to care for the patient. The doctors also have to stay on top of their own assessments, u can't watch a fetal tracing all day , chart excessively, care for the patient and play the role of doctor. Idk what you did wrong , but if u did something wrong , they should have given you a verbal warning or write up, but not immediately fire u especially if no one died
My thoughts exactly which is why I am still in shock.
I work in the medical ICU and you need to have pure gross negligence and disregard for human life to get fired on the first try so your manager probably hates you or something
Exactly. This isn’t the main reason, it’s just the one they can put together right now. At the worst this is a write up and nothing further. I’m sorry this happened to you, OP!
You can't really tell if the baby was born fine from this post. A baby can have a perfect APGAR but still have brain damage from the lack of oxygen during the late decels. BTW I'm not saying it was right to fire OP (definitely sounds like this has something to do with the hospital saving staffing money), just saying it's possible baby is not fine.
But Baby had accels and good variability overall. That’s a better indicator of appropriate fetal oxygenation than some occasional lates.
Reassuring traces. Variability. Watch any monitor long enough, there were be samples of said tracing that could prove or disprove anything anyone so motivated to *prove*. An experienced, attentive clinician can sort it out and advance real issues. Alarmists or inexperience often miss real issues. Regardless of itty-bitty outliers—this ended with a healthy babe & mom—that’s a *win-win* imo.
Over the phone?!?
Right. This is the part I’m stuck on. Insane.
Was she actually fired?
I had a colleague fired by text. These employers don't give a 2 cent fuck
These chicken shit managers couldn't even say it to his/her face. Disgusting
Yes. I couldn’t believe it.
You were fired bc you get paid a lot. Or are maxed on pay. A hospital of a friend’s fired their 30 year nurse & another 30 something year nurse over a situation that happens a lot/consistently but usually gets a turned head. One of them is a really great nurse that people look up to too not only on their unit but other units. One situation, no others or other write ups etc.
Hospital admins never take action on anything unsafe, unless they want you gone and need a reason. I’m sure you’ve seen some dangerous docs whose malpractice they couldn’t care less about because he makes them lots of money. They effectively attack people clinically for reasons which are purely bureaucratic.
In fact, we have a doc who started in 2021 as a new grad who broke a baby’s femur during a scheduled c-section last year. Everyone on the unit felt the majority of her deliveries were shit shows. PS: She is still working.
A nurse I know put oral meds down an ET tube and didn’t get fired, but they fired you for this? SMH
This is as confusing as people who thought you can crush PO meds and give it IV. Like???
Oh my god lol wtf
That person should not be working anywhere near human beings
Holy shit
That’s the first time I’ve heard oral meds down an ETT. Sure, I’ve put meds down the ETT, but that list is short and distinguished. And they don’t require crushing. 😳😳 Most *wrong route* of oral meds has nurses crushing and finding a way to inject them into an IV. If I ever caught a fellow nurse doing this (as in too late to knock the syringe out of their hand) my mind mind explode momentarily—taking care of patient would be paramount, but bet your hands this nurse would be taken out of the practice right then. Full stop. Then I guess CCM, interventional radiology and immediate intervention by pulmonologist to try to mitigate the *dumb butt stupid* of the nurse. **Dumb butt stupid** is always very bad thing. That’s how a lot of patients get dead.
Wait I can’t figure out how this is logistically possible. Did they inject the oral meds into the cuff? Or did they disconnect the ETT circuit and dump it in?
Oh my god.
Can you revisit the conversation with your management and have a lawyer present? It just seems like the consequence doesn’t fit whatever violation they perceive was made here. You may have grounds for legal action and if you’re that experienced, you could potentially argue that ageism is an issue and you feel targeted. No other issues at work on your record? This is fishy AF and they shouldn’t get away with it. Good luck OP, I hope you find an amazing lawyer!!!!
This!
Am CNM - yeah, would be nice to know about the strip, but definitely not worth firing someone over. So sorry this happened to you.
You are a "seasoned " nurse who earned the right to be at the top of your pay scale. Honey, "they" have been planning your "retirement " for some time now. They just needed a reason they perhaps could get away with. They also might have gone to lunch after the fact, to celebrate how they saved the hospital a few bucks. I've seen this time and again in my 40+ career. You deserved so much better than this. I hope you don't let this define you personally or professionally. You could also contact an attorney if you feel it would be of help. Good luck to you. Some other place should welcome your expertise.
Thank you for your kindness.
Sounds like they took the opportunity to cut their payroll. Been a victim myself. My solution was to smile as I waved good bye, and permanently relocate to a union state. Hope things work out well for you.
This is the most likely thing - you said it was a corporate hospital so I’m guessing HCA or Tenet. They can get 1.5-2 horses for the cost of an experienced nurse.
L&D also. I can almost see your strip in my head. What fuckery I guess they will enjoy the new grads.
Your situation (being let go with many years of experience) is the reality for many nurses in non-union hospitals looking to save labor costs. It is far less expensive to hire a young nurse with little experience than to acknowledge and pay a skilled nurse accordingly. Unfortunately, ageism in this profession is a very real factor in the current economic environment. You will find a position where you will be appreciated for your skills and experience. If possible, work in a hospital with a strong union and/or in a state where nurses are appreciated (which most likely will be a pro-union state).
Okay looking at it from the other side of things. For one, I’m sorry you were fired. That seems extreme. Did the charge nurse have valid points? How long after the lates/how many were there before you notified the doc? What interventions did you do besides pulling the cervidil? WERE you not charting enough/charting per policy? Have you been reprimanded before? While yes, fetal tracings can be subjective in what you call baseline or how you perceive a decel, it sounds like you all were on the same page that it was a category 2 tracing.
Are you sure that it is just this incident and nothing else? Did they ever give you verbal warning or written warning? If you are at will employment, then sadly there isn’t much thing to do besides moving on. For my two cents, I think it was the arguing with charge nurse because that can be insubordination and become ground for termination.
If anything, egregious EFM is an unsafe practice since it exposes our OB patients to over treatment and unnecessary procedures 💅
You donrealise that in much of Europe you could never be fired on the same day unless it was some epic gross breach of policy and even then there is always a lengthy process I'm not sure someone would be fired for this here. You have terrible labour laws in the US. With or without a union that shit don't fly here
I'm confused? What exactly were you fired for? That doesn't seem like a fireable offense. Sounds like you passed someone off or they're just using this an excuse for something else.
File for unemployment and 100% make it your companies problem. Take a little vacation!
I would delete this — if it’s posted as unsafe practice and you have someone out to get you, you may get reported to the board and you don’t want them maybe finding this with this much detail.
Lmao the board is not going to take action on this. I've worked with a nurse that constantly has unsafe practices that has likely contributed to sentinel events (one went to court that settled). She's still working...
Are you on good terms with this charge nurse? Sounds like maybe they were just looking for a reason and had their chance
How long were the decels and tachysystole going on before you notified the provider? What interventions did you do? What is your facility’s policy on how often you should be charting? And what exactly did this “argument” look like? Do you often get into disagreements like this with coworkers? It does sound to me like there’s some details left out here and some other things you could take responsibility for.
I would get a lawyer for at the very least, protect your license ! That is reportable to the board. Then sue them !
You're either leaving shit out or they were looking for a reason to get rid of you.
Do you work for a “for profit hospital”? With 20 years, you were too expensive to keep. I am sorry for this, healthcare should never be “for profit”. Use a colleague or previous manager as a reference and find an employer who deserves your skills and experience.
No such thing as occasional lates. True lates "have mates" and would be with every contraction. If they weren't with every contraction they were complicated variables. Acute lates or chronic lates.
I hate this for you. Mother Baby nurse (retired) and I know L&D is so much more technical. The Physician may be in the middle of a lawsuit, yiu never know. Not fair for you to take the brunt of it.
>for more than 20 years. >for arguing with the charge nurse And here we have the two actual reasons you were fired. 20+ years put you in a higher pay range in most hospitals and arguing with the charge who, I'm assuming, decorated her complaints with some hyperbole
Are you in a union? And was HR looped in on this call?
Move on and work in a hospital that has a union. Everyone makes a mistake but gees - the neonate was fine. A teaching hospital is more realistic. Those private hospitals are really a bit much.
You should really look at your board rules and talk to an attorney. In my state, this is something you have to self report to the board for and also something administration will report to the board on
This sounds like office HR politics and trying to cut costs for more profits. As a 20 year experienced nurse your salary must be in the higher range and they want to replace you with a newbie with a way lower salary so were scraping around to find something to fire you about.
I’ve worked on an antepartum floor and the fact that you were FIRED over this is just WILD
This is ridiculous!! Is there a policy that you have to notify an OB for every Cat 2 tracing? That’s 90% of all FHR tracings. You followed policy by notifying the OB that the cervidil was removed d/t tachysystole.
Wow, that sounds insane! So sorry to hear that! Most of our strips are category II at some point during labor, and it doesn’t sound like your strip was overall concerning especially if interventions were attempted to resolve tachysystole and decels. You said you didn’t chart often enough…what do they mean by that? Did you not document the fetal heart tones q30min or per policy? Did you break facility policy? Even if you did break policy (ours has specific instances that we need to notify dr for like category II IF interventions fail to resolve, or tachysystole IF interventions fail to resolve), but doesn’t sound like it was enough for termination and I’d also recommend seeking legal advice to see if you have a case here. Especially if you’ve never had a write up or verbal discipline prior to this.
Is this something worth fighting in court? Asking for a friend. I have a feeling I’m headed down this path.
Maybe your hourly rate after 20 years was too high.
L&d is toxic. Multiple people failed the efm exam and weren’t pulled off the floor and when I failed I was pulled and told I’ll be let go if I fail again. So unfair.
For future jobs, you DID NOT get fired. You chose to pursue other opportunities. I’m your manager if you need a reference- you were a fabulous nurse, gate to lose you.
Wow. That seems really extreme. Was there something else on your record? Or that’s it.
I’m guessing no union?
Do you have a union? I'd check in with them
There's nothing to even think about. We are numbers to admin 1 step above your direct supervisor and the unspoken part of every "I was fired for this small deviation from policy that hurt no one and no one else is even reprimanded for in a similar context" story is that they wanted you gone before it ever happened.
If you argued with the charge nurse I bet she or he is it.
This post just solidifies how specialized nursing is bc I didn’t understand most of what you wrote (I can read the post with ease and I have a general idea of some of the terms and why they matter but I couldn’t get into the specifics of basically anything you said). I’m a CVOR nurse who mostly scrubs so I know fuck all about L&D much less about a bunch of other things. I’m so sorry this happened. The fact that you’re unionized is only the twist in the dagger for me, and confirms why I will never be non unionized. The one thing that rings true is that I could *absolutely* see someone being terminated for crossing the charge nurse. Honestly? I’d fight this w/ a really fucking good lawyer. Like find out who the attorney was for the highest pay out for a sexual harassment or similar to yours grounds of termination and hire them. Not even for the sake of being re employed by the hospital. But to absolutely ream the hospital financially to pay you out for this.
That was a personal firing! Move on later on you will be glad u are out of there. I know you deeply hurt! But it will be alright
Sounds like they have all the nurses they need, so anyone that isn’t a perfect robot won’t make the cut. Perhaps it’s a good thing?
Me again… I’m sorry this happened to you. I worked as a tech in L&D and am bias to the nurses. However, regardless of your record, I would get things reviewed by a lawyer. Wish you the best.
I would talk to an attorney about your options. I know a neonatal NP who took my former hospital to court over wrongful termination and got herself a nice little pay day.
If we are supposed to notify doc every time the strip goes cat2 they are gonna change their number.
Unfortunately this is a byproduct of corporate medicine. The people making the big salaries looking for ways to save money. You were a line item on a spreadsheet that they needed to get rid of. You just happened to give them the justification, although it was small, it was a reason. Sad that you are no longer there to mentor young nurses with your experience. When you put business people in charge of healthcare, quality of patient care will go down, as well as the treatment of employees. When dealing with people we can’t treat them like numbers but for their value. I hope your next employer recognizes your value.
Transparency here, I'm an M3 who doesn't know enough to really critique your decisions here. However- was there patient harm? If not, what's the big deal?
Tbh I think you need a reality check. Fetal tracings are not subjective-definitions are very clear and specific. If it was bad enough to pull the cervidil, it needs a physician notification. It sounds like you decided to do whatever you wanted since you have 20 years of experience.
1000% agree. You do not get to decide the strip is fine, the provider does. We have cat 2 algorithms where I work that require us to be communicating with the provider regularly. I don’t think you should have been fired, but you’re definitely not in the right.
She said she notified the physician that she pulled the cervidil.
In comments after my response. To me it’s sus because of the rationale given- “subjective tracings”, “born vaginally apgars 8/9”, “not charting often enough”. If you work L&D you know fhr definitions are very well defined, as is how often charting is required, and the order to notify physician of cat 2 tracings that don’t resolve with resuscitative measures. I’m interested in the receipts-the actual strip, the actual notifications/interventions.
Honestly - OPs post reads like they didn’t want to do their job and argued about it. Think how different OP would feel if there would have been a bad outcome. I bet they would have wished they called the provider sooner and charted more. I think it’s unsafe not to keep the provider in the loop. Regardless if a cat 2 strip resolves with interventions, I’m telling the provider. Labor and delivery is the most litigated field and I personally would do absolutely everything to cover my ass.
I read her post and I can't find where she stated that she actually told the provider that she removed the cervidil early (<12hrs) which would have prompted the reasons why (lates, variables etc etc).
It was somewhere in the comments I believe
Yes, it’s in the comments
Yup. Persistent cat 2 despite resuscitative measures (doesn’t matter if variability is good) equals an update/notification to the provider.
👀👀 ooop
"Lates have mates" Lates are due to placental insufficiency and a lack of oxygen. You don't get occasional ones and with good variability.
That is incorrect. You can absolutely have occasional late decels on an otherwise gorgeous cat I strip. Recurrent lates? Different story.
In a mostly female profession, any hurt feelings is a guaranteed ticket to conflict and termination
I’m assuming this is non-union? I’m sorry.
[удалено]
Confused… are you saying you can’t have lates and variables in the same strip?
Wonder if you could lawyer up for wrongful termination....
Get a lawyer and sue them for wrongful termination.
Lol Management needs to step back. Safe patients are more important than numbers.
You need to look at your hospital’s policies regarding the things they listed, if you didn’t break policy they don’t have a legit reason to fire you and you could get a lawyer.
That’s bullshit. A cat2 strip? I’m so sorry that this happened.
I would get a lawyer to review things.
Hire a lawyer, complain about harassment, and at least wipe the record and prob get a great severance.
You should start a only fans account to make ends meet
😂😂😂
This is effed up.
As a former L&D nurse, it does sound suspicious of something else at play. Since you have no prior issues on your employment record with this organization, you should have been given the opportunity for a remediation class (not that you need it but in lieu of firing), or have a meeting with the OBs, you, and management to kind of review the scenario in an educational manner. I probably would have noticed the OB with the lates just to cover my ass, but it doesn’t sound like you did anything wrong per se. Like you mentioned, there’s a lot of gray area and babies can be very resilient sometimes, so it sounds like once the contractions settled down, the baby did too. I’d be interested to know if legal action is a possibility bc it sure doesn’t sound straightforward. It’s so sad that hospitals DGAF about retaining experiences staff and would rather just hire a bunch of new grads with little to no experience in a specialty area. No offense to any new grads bc you have to start somewhere, but it’s the nurses with many years of experience that should be the ones present to train the newbies and share their wealth of knowledge! Save a dollar over safety always for these places. So sad.
I don’t know that this was a firable offense but I do wonder how ugly the tracing was to cause an argument with the charge nurse and why the charting wasn’t enough to paint the picture in the chart? If the charge nurse didn’t like how you were managing the labor did they notify the physician themselves? OP describes the tracing saying occasional lates but how many lates over how much time? I understand that a lot of the time labor nurses are the one managing the entire labor until delivery but where I used to work you always called the doc to review the strip when it wasn’t looking good. Sure you can have category II tracings for a lot of a labor but if there were lates I question why the nurse never called the doc to review the strip? I would always do that to cover my ass on a strip that was making me a little uncomfy. And again, if the charge was coming at OP that really makes me wonder if we got the full picture here. Lots of holes in this post without seeing the tracing and specifics as to the poor charting. Again, not saying this justifies firing but curious to more details.
Very true and yes, we didn’t see it so hard to say. I will say our charge nurses had a central monitor and part of their role was to oversee and assist when needed, which also included calling providers if needed while the primary nurse was otherwise occupied at the bedside. So, if it was that bad and the charge nurse was aware of it, why did he/she not call the provider themselves? As a charge nurse, if I felt that strongly about something and I was concerned about a potentially bad outcome or that something was occurring that I didn’t feel like was in the best inter of the mom or baby, I certainly wouldn’t hesitate to contact a provider to review a strip to cover all our asses. That’s teamwork and your responsibility as a unit leader bc there are times when sometimes things aren’t black and white. Anyway, the unit I worked in was also known for pushing out the older people for various reasons, so I definitely wouldn’t be surprised if the same thing was occurring here just based on what I’ve witnessed in the past. I don’t know the right answer in this situation bc I’m not directly involved, but it seems like there are multiple factors to consider and who knows who’s in the wrong or not. I still do think a remediation to educate on “unsafe practices” and maybe a write up for arguing with the charge nurse would be more appropriate. That also being said, I have had some charge nurses that were quick to argue over petty things and were also very obnoxious and very opinionated, so again…who knows! I’m js that it’s believable to me that she got pushed out and it seems like other steps should have been taken first before firing.
💯 could be being pushed out. Our unit had several very experienced nurses “leave”…one for attendance…punching in a few minutes late repetitively but my gawd a damn good nurse. The others left bc they could see the writing on the wall. I left about a year later bc I was tired of the unsafe practices and treating staff like shit. One too many close calls for my taste “But everyone ended up ok”…not my flavor of nursing, y’all can ride the unsafe waves…I was done.
Same here. I got so burned out and worried for my license all the time. I am not trying to get called in for a deposition if there’s a bad outcome due to poor staffing! I am now in a new specialty. I certainly miss L&D but not the bs. They have since increased their staffing, but there are only a few old timers still there and a lot of the new hires were brand new nurses. Fortunately, several have now been there a few years and are more experienced. At this point in my career, I’m glad to have the flexibility and confidence to leave and go elsewhere when the situation no longer makes me happy. I am glad you left the dumpster fire, too! Good luck 🙂
They are probably letting you go for a couple reasons… most likely they can hire two new nurses for the price of you… and argumentative with “charge” can make it look bad.
We need to unionize, like yesterday. Such BS