How bad is it?
August 16, 2012 8:48 PM   Subscribe

Moment of crisis. Wife was fired from nursing job; now she's concerned that future nursing jobs may be partly or entirely beyond her reach.

Without going into too much detail, she made a fairly minor mistake that had major enough consequences (* not a death) that they fired her the day after. This was her first nursing job after attaining her RN and she'd had it for almost 8 months. She has no intention of contesting the termination in any way; she feels that it was justified.

To what extent is this likely to impact the process of finding a new nursing job? She's going to be looking at different types of settings than this last one, but she has always had a notion of being "not a typical nurse" (i.e. outside of a hospital setting; she has more interest in preventative care than dealing w/acute situations) and while this termination may seem like an opportunity to explore that, the fact that she was fired would seem to close doors rather than open them, particularly in this field.
posted by anonymous to Work & Money (12 answers total) 4 users marked this as a favorite
In health care, a minor mistake with major consequences is in fact a major mistake.

My partner is an RN and she says it could well impact the chances of future work depending on the nature of the error, whether the hiring managers talk, whether the licensing agency is involved, the toxicity of the environment towards new RNs, and many other things. A lot hinges on the details of the error committed.

She also points out that if the licensing agency felt the error was serious enough, they would pull her license and that would be that. Presumably it wasn't an offence that mandated reporting to the licensing agency?

Anecdotally, one of the areas my partner works recently hired an RN who lost her previous position due to stealing narcotics. She's not allowed to dispense narcotics anymore but she still has her license and still works in a hospital setting.
posted by Sternmeyer at 9:44 PM on August 16, 2012 [1 favorite]

Generally speaking, when you are fired for a major mistake, they tell you to speak to how you learned from it in the interviews for new jobs. Presumably this could be the case here. I am not a nurse or health professional or HR person, however.

Can you take an additional class or certification that addresses the area of your mistake? Not only for the practice, but to prove that you have learned.
posted by blnkfrnk at 11:03 PM on August 16, 2012

Would it be better for her to work in a doctor's office, or a clinic?
posted by Cranberry at 11:10 PM on August 16, 2012 [2 favorites]

A clinic, public health or home health all sound like a good next step. In my town, the long-term care wing at the hospital seems to be the natural launching pad for all new nurses.

In the "not a typical nurse" vein, just how flexible can you be? States like Alaska have nursing shortages and lots of opportunities.
posted by AnOrigamiLife at 12:52 AM on August 17, 2012

Your wife should consult with her union rep even if she has no intention of fighting her dismissal. My dad was a labor relations specialist for a university hospital for 25+ years, and from what I've heard over the years I would say that it is very likely that her rep can provide her with information and options on how to move forward with her career as smoothly as possible.
posted by xyzzy at 3:03 AM on August 17, 2012 [2 favorites]

She might consider getting work in medical research.
posted by vitabellosi at 4:01 AM on August 17, 2012

Or she could make no mention of the job, or the firing, on future applications. Accounting for a gap of 8 months in this economy isn't too hard.
posted by LonnieK at 5:03 AM on August 17, 2012

@LonnieK - That is specifically forbidden for any medical staff or allied health professional seeking privileges at an accredited hospital. When a hospital credentials you they have to get records from every facility where you worked. I've never done credentialing for clinics, but I would think they go through a similar process.
posted by missmerrymack at 5:41 AM on August 17, 2012 [6 favorites]

Husbunny used to be a nurse and the stress of dealing with patients and making those kinds of mistakes was unhealthy for him.

One job he had was working on care-plans at a nursing home. He and another RN did administrative paperwork, with little to no patient interaction.

Another job he had was working with a MAJOR insurer in the Asthma department. He worked in a call center and called people with asthma as part of a chronic disease managemet program. They have them for diabetes, obesity, high blood pressure, you name it.

Or she can be the "On-Call" nurse, the one people call in the middle of the night if they have a concern or sick child.

When discussing her termination with prospective employers it's important that she explain that she made a major error, and accepted the termination as a consequence of that action. She can then say, "What I learned from this experience is...X. One of the reasons I believe that this type of nursing would be a good match for me is that it reduces the risk of my making that kind of error, and I've always been interested in this type of non-traditional nursing role."

Everyone makes mistakes, that's why pencils have erasers. Nursing is a very stressful job, and it must be done perfectly to insure no bad outcomes.

I don't think this makes your wife unemployable in the future, but she may need to re-build her reputation.
posted by Ruthless Bunny at 6:41 AM on August 17, 2012 [1 favorite]

I'm presuming the error was medication related. Please have her check the Institute for Safe Medication Practice website. I highly recommend subscribing to their newsletters where med errors are discussed in-depth and the focus is on institutional improvements to reduce the errors. The ISMP is against firing nurses for errors (remember - we are not talking about unsafe practice which is a different animal) since it reduces the likelihood of nurses reporting errors if they suspect they will be fired for it. The ISMP call it Just Culture and calls for hospitals to recognize their shared accountability.

The fact is that everyone makes mistakes. I joke with my husband that every time I read the medication error case histories in the ISMP newsletter, I say the nurses prayer "I could have made that mistake, thank god it wasn't me!"

She should consider taking some of the courses ISMP offers and marketing herself in her next interview as someone who made a mistake and aggressively educated herself on medication error-reduction.

A final recommendation is for her to read The Checklist Manifesto by Atul Gawande. It's a fascinating read about reducing errors in complex systems.

Please tell her that making a mistake does not make her a bad nurse. Every nurse and every physician who practices for any length of time has made a mistake. Recognize the error, think deeply about how it happened, and vow to make sure it will not happen again.
posted by TorontoSandy at 7:59 AM on August 17, 2012 [11 favorites]

Maybe Vegas is different but nurses get fired here for some pretty serious stuff and show up at another place almost immediately. Home health seems particularly forgiving in my area.
posted by yodelingisfun at 10:55 AM on August 17, 2012

@missmerrymack --
Thx. I wondered about that. If that's the case, I'll withdraw my advice.
posted by LonnieK at 6:46 PM on August 17, 2012

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