"new grad-itis"...

It too shall pass! Most have the second form and something will happen to put him/her in his/her place with a wide-eyed wake-up call.

Usually the Know it alls fall flat on their face in no time. After they fall their attitude usually changes. I'm teaching a class right now and I have one of the Know it all type grads. I'm sure in a couple of months she's going to stumble into something over her head and I hope this brings a change in attitude.

My concern in these situations is that there is always the risk of someone who feels that they don't need any input or help charging forward blindly. They can quickly get in over their heads and rather than ask for help, they might keep trying to go it alone. In the wrong situation, it could be fatal for a patient.

I used to see this every year in June and July when the new crop of Interns, Residents and Fellows came in.

The ones who came in quietly, looked around the NICU w/deer in the headlights eyes were so easy. "I don't know nuthin' about no premies, mam." "Come on, sweetie, I'll help you."

The ones that came off like, "I just graduated from medical school. Start groveling." were in for a tough time. And, no, not just from me. Every one from the attendings on down would be gunning for them. By Christmas, they were tolerable.

Ask some of the more experienced nurses about dealing w/the smart-ass newbies, or just follow their lead. They'll be standing back, just watching..... They WILL try to prevent harm, tho.

Prayer from a new grad in the er:

Please, <insert chosen diety here>, please, do not allow
my foot to slip in my mouth
or my head to get too big
Keep my eyes wide open
my attitude humble so
that I may succeed...
and not **** off too many of
the nurses I someday want to grow
up to be like. AMEN.

After 20+ years of dealing with New Grads I've had plenty of experience with all three kinds. Your type I adore. You may start out timid, but you watch, you learn and you grow into terrific ER Nurses. The second type tend to remove themselves from anything they are unsure of. These you'll find in the bathroom during a code. With an understanding, nurturing preceptor about 60% do succeed. The third type ;The "I Know it All " type are dangerous. They don't ask questions, they just speed through things, not even noticing they are making mistakes. They need to be watched constantly. We had one recently that decided he would give PO contrast to a patient with a probable perf'd bowel. An astute new nurse stopped him and called over a preceptor. He immediately started arguing with that nurse who had been a nurse long enought to have delivered him. He just wouldn't shut-up He was taken off the floor, sat down and made to explain everything that could go wrong with what he intended to do. Than he was told what the worse case senario might be. That would be "DEATH" That humbeled him for about 2 days, Than he was back to being his old know it all self. I'm really not sure he is going to make it. Very few of the "Know it all" make it very far. An a few of them end-up with law suits. Many experienced preceptors refuse to precept these folks because of the unacceptal risk associated with their behavior.

Take your time, Make sure you understand what you are doing and what the expectations are. You sound like you will be a good, caring, conscious nurse and any hospital would be thrilled to have you.

"Not the way we did it in school??!!"
Good grief! That sort of attitude would make a saint curse, I think you have every right to be annoyed!
Feel free to post my literary work, or slip it directly into select mailboxes.

I am a brand spankin new nurse and I can't imagine I know everything. I feel like I know about 1%! I have also worked on this floor as a CNA for 4 years and thought I would have it easier, but so far no! There is still so much I didn't realize about being a nurse and the patients we care for! It scares me about some new grads and how they think they know everything! It is those types who will get in trouble with something and be afraid to admit their mistakes and ask questions!!!!