Recovering from a mistake in nursing
January 3, 2014 11:40 AM   Subscribe

I'm a new RN but was terminated after I screwed up and verbally abused a patient. Help me figure out what's next.

Two weeks ago I lost my cool and cursed at a nursing home resident I was caring for, and was terminated for verbal abuse. This was my first nursing job and I was right at three months with them. Although I've yet to get a callback from the North Carolina Board of Nursing, the director of the home indicated she would have to report the incident to them. She doesn't think I'll lose my license, but I have no idea what the procedures are. I understand I did a very bad thing and am not making excuses, but I like nursing and would like to continue my career. I believe this is something I can learn from and move on (a sentiment echoed by the Director who fired me), but I have no idea how to improve or explain the situation in interviews.

NC has a Practitioner Remediation Enhancement Program but it specifically rules out abuse, so I have no idea whether verbal abuse is included. (It probably is.) Is there something I can do now that I can later use to say I've taken steps to solve this problem? How do I even talk about this in an interview?

If you have a story of a massive early career screwup that you've recovered from and thrived afterwards, that would be nice to hear too, as it's hard not to feel like this is a massive failure.
posted by anonymous to Work & Money (10 answers total) 5 users marked this as a favorite
I suggest some sort of anger management program/therapy. It's not the sort of thing you'd want to talk about in job interviews, but if you were asked about it, that seems like a reasonable answer. You would need to be able to reflect on your experience in such a way that the interviewer would be convinced that you understood why it had happened and had developed effective coping mechanisms to avoid it happening again.
posted by treehorn+bunny at 11:49 AM on January 3, 2014 [18 favorites]

My niece just got her RN in NC and is working in a nursing home. I wonder if maybe your former director has decided not to report this now that the heat of the moment has passed. Working in nursing homes can be more stressful than working in hospitals or other places, and maybe you're just not well-suited to working with this type of patient.

Verbal abuse is a kind of nebulous and subjective term. I once told some very difficult teenagers I was working with to "sit back down, dammit!" and one of the kids reported me for "cursing him out". My interpretation was that maybe if I'd said damn you to hell, kid x, you useless fucking so and so, it might have been verbal abuse.

Can you work per diem in the meantime? You still have your license. Can you ask any of your former nursing professors for advice?
posted by mareli at 12:39 PM on January 3, 2014

Your desire to seek support and encouragement is understandable, but the loss of professional licensure is a legal matter, which like most legal matters, isn't likely to benefit from the uncounseled and public revelation of facts. There is, almost certainly, an attorney in your jurisdiction that has represented medical professionals in board proceedings who might be able to help you with the first step of keeping your license. If you accomplish that, then asking for interview management advice may be fair game, but doing so without making potentially damaging admissions is probably in your best interest.
posted by MeadowlarkMaude at 12:46 PM on January 3, 2014 [3 favorites]

If you're asked about it, use the format of Context Action Result.

Context: "I'm a new RN and still learning on the job. During my probationary period and while learning what nursing home work is right, I made a mistake-- I let my temper get control of me toward a patient and my boss made the decision to terminate my employment."

Action: "I knew I had to learn from it, so I've pursued anger management therapy and spoken with my old professors about it. Moreover, I've realized that what I excelled at in training was in XYZ type of environment, so I'm trying to focus on that now."

Result: "I've learned a lot and will never, ever allow myself to lose control like that again. It was a low time for me, but I'm coming out stronger for it."
posted by samthemander at 3:20 PM on January 3, 2014 [5 favorites]

> I let my temper get control of me toward a patient

I'd give a little more detail, though, to make clear it was cursing (bad!) and not violence (unforgivable).
posted by The corpse in the library at 3:25 PM on January 3, 2014 [5 favorites]

I'd give a little more detail, though, to make clear it was cursing (bad!) and not violence (unforgivable).

Yes! If pressed, go for wording like, "I delivered the proper care but lost my temper and used inappropriate and unprofessional language," so they know you weren't yanking things around, handling anyone roughly, etc.
posted by blue suede stockings at 5:39 PM on January 3, 2014 [3 favorites]

You need a lawyer who specializes in cases like yours. It;s worthwhile to protect your license.
posted by theora55 at 9:10 PM on January 3, 2014

Are you a member of a nursing college (not the regulatory/ licensing body, but similar to a union - here in the UK we have the Royal College of Nursing; a quick google throws up the NC Nurses' Association). If so, call them and ask for help and representation; if not, consider joining!

Otherwise, do you know why you did it? Have you reflected and found your trigger points and worked out strategies to help you choose a different course of action next time? I mean really - not just thinking about what you can say to save your license or get jobs in the future - but really. You verbally abused a vulnerable person after only three months as a nurse, which is extremely serious, and if you want to be a good nurse (which you're not, yet) you need to know why and how that occurred and how you can be sure it won't happen again, whether you have to explain your actions to a tribunal or not.

And think long and hard about your personality and lifestyle and circumstances and what type of nursing will be the best fit for you (your school should have helped with this, but now you really have to think about what you will be able to actually do for 8-12 hours, five days per week). Working with people with dementia is hard. Palliative care is hard. The NICU is hard. Secure forensic unit nursing is hard. Less hard is a day surgery ward in a hospital, or general practice nursing, or theatre nursing (you don't get to know the patients, which makes it easier in my book). Think about what is actually involved with the types of patients and the situations you will be encountering, and how you will control yourself when providing health care to vulnerable and sick people in future.
posted by goo at 9:55 PM on January 3, 2014 [2 favorites]

I used to be an ADON at a nursing home and I'm sorry, verbal abuse is abuse, bottom line...but the more disturbing fact is that this happened 3 months into your career. On the minimum, you need to be mentally evaluated. Our board of nursing offers "peer assistance" to nurses for addiction/mental issues. You might want to check and see if NC offers anything like that. In our state, I know there is less repercussion to the nurse, if he/she comes to the board and asks for help before they are reported. Maybe it's the same in NC?
I know here, it usually takes 8-10 months for a case to be heard after submitting it. I know that the case I submitted October 2012 to our board for a drug-stealing-fake-charting-fucked-up-on-the-job nurse and it was JUST reviewed in November, so your board might be behind. I'd do a little investigation and find out what your options are. It might be in your best interest to "come clean" with the board first.
posted by Amalie-Suzette at 12:16 PM on January 5, 2014

I am new grad nurse, not in North Carolina. I am so very much not a lawyer.

Wait until you hear back from the board. This time of year, it can be a while before you hear back from people.

Get a lawyer, one who specializes in employment law, if you can.

Talk to your former professors, get some insight/advice on what to do next. I don't think you can work per diem at the moment: there's usually a background check to get a new job. Do you have any evaluations from them from clinicals you could take to the board? Character references, progress notes, anything to show losing your cool is not going to happen again?
posted by RainyJay at 3:16 PM on January 5, 2014

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