I’ve been fired three times and am therefore an expert on this topic (I’m a slow learner). The main issues I’ve gone through are: a) trying to be speedy in my work, and b) not caring about others’ perspectives on the job. What follows is an analysis of the reasons you might get fired as a male nurse, especially if you are in your twenties or thirties.

1) You want to show your competence by being speedy in your job. Wanting to be fast will, in turn, lead to shortcuts that will get you fired.

In my first nursing job, I started things off by cheating a little bit at a time. At first, I falsified blood sugar readings by making up numbers when I charted (taking blood sugar readings on 3-5 patients in the mornings took way too long and I deemed it to be a waste of my time). Naturally, no one caught me, so I pushed a little further by falsifying blood pressure readings (which I was supposed to take using a sphygmomanometer). My justification was that if my unit was too cheap to buy automatic blood pressure machines, then I’d be too cheap with my time to care about measuring blood pressures the old-fashioned way. After a month of getting away with falsifying patient data, I decided to up the ante. I started to chart medications without caring to scan the individual barcodes. Three months into the job, I felt unstoppable in my “efficiency” endeavors. Eventually, I got caught in the act when a charge nurse dinged me for “giving” a medication to a patient who was actually off the unit when I charted that I gave the medication. From that point onwards, a red flag was placed on me, and all the charge nurses were told to scrutinize my behavior and charting. I subsequently ignored a heparin order, left medications unattended in patient rooms, and left sharps uncapped on mobile computers. Then I got fired!

I am not telling you to avoid shortcuts, since taking shortcuts is inevitable (everyone takes them). What I am saying is that you need to watch out for your internal desire to be fast on the job. Whenever your emotions tell you to be quick, just understand that a charge nurse might be watching you. That said, my best advice is to play by the rules in your first three months on the job. Once you get a feel for the shortcuts you can safely take, execute them with extreme prejudice. But if you get onto your boss’ radar, be ready to play by the rules again.

2) You think you know better than your coworkers, who have more experience than you.

Here’s the situation: you got a great score on the SAT, and you graduated at the top of your high school and college classes. You passed the NCLEX on your first try in 75 questions. In your teens and early 20s, you were the man. You also graduated from college debt free. You therefore know everything and should be automatically promoted to CEO.

Once you hit the nursing floor, you realize that you are not that special. You have to listen to doctors’ orders just like the forty year old nurses next to you. You also have to dip your fingers in bodily excrement just like the fifty year old CNAs (nursing assistants) you look down on. All of a sudden, you realize you need help with the smallest things, like figuring out where the urinals are located and how to call a Code Blue if a patient stops breathing. But how could this be? Didn’t you get a great score on the SAT? Didn’t you pass the NCLEX in record time?

When you carry yourself in an entitled way, it rubs off on your coworkers negatively. The consequence is that when nurses sense that you’re cocky and are not coachable, they refrain from giving you valuable intel. My advice in this situation is to be coachable. The main way to achieve this is by asking questions, especially to people that have more than two years of experience on the floor. When nurses actually do offer advice, ask yourself why they would say that, and if the advice is valid.

I will repeat what Ray Dalio said in his book, Principles. Your goal should be to know a great deal and to also be humble. In my experience, a good strategy to attain this goal is to assume that your coworkers know something that you don’t. That way, you’ll listen and remain coachable.

All that said, not asking questions is probably the most dangerous thing you can do as a male nurse. Not asking questions leads to the lack of information, which often leads to mistakes that can get you fired.

3) You think you are above certain tasks, like cleaning patients and dipping your hand in shit.

I’ll give you a hint: you are delusional if you think you’ll delegate the dirty work of nursing to CNAs. Learn how to be humble in cleaning patients and how to ask for help to protect your back.

If you develop a reputation for delegating cleaning tasks or for not cleaning your patients at all, expect a counseling meeting with your unit manager. If your behavior continues, expect to get fired.

4) What follows are a couple of other reasons I got fired that came from left field.

a) I wrote an email to myself calling my boss a nig*er who should be raped many times. I never sent the email. Rather, I saved the email as a draft. Little did I know that the security personnel were monitoring draft emails! I was foolish in drafting the email on my work server.

b) I violated universal precautions continuously by not caring about proper syringe use and by not caring about throwing sharps in the correct containers. Is it really possible to get fired for such small infractions? You bet it is!

I’m not going to tell you to play by the rules. Some people break rules because it’s in their DNA to be disruptive and cunning. I will say one thing, though. Be self-aware about who is watching you on the job!