When did you realize that "newbie" wouldn't cut it in the ER? - page 2

by lvnlrn

16,140 Views | 44 Comments

Just curious to hear some of your stories regarding orienting nurses (either new grads or transfers) to the ER and when/how you know if someone is cut out for the ER or not.... Read More


  1. 3
    Quote from Heavenlee75
    A lot of nurses forget that at one time they too were new...I have a huge problem with nurses who think they're better or smarter than the next! I'm an experienced nurse who has oriented new nurses and student nurses and I enjoy teaching. The ER is a stressful place and although it might not be for everyone nobody should ever be made to feel like they're a burden to other nurses because they're new. That's why nursing is so stressful these days...bad attitudes to others!!!
    Absolutely! I'm so glad you have that attitude as an orientor... You have to! I enjoy teaching the students and newbies on our floor also. I mean yes, you do get those individuals that ask questions about basic nursing care that they learned in their first semester and are now in their last, or graduated already.... But those are usually the ones that don't make it.
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    When the noob administered PO benadryl IVP and called the diphenhydramine an abx.

    ....


    I don't know much else.... just something i heard.
  3. 1
    Or, how about when a seasoned nurse who has "many years of experience in this setting" establishes an IV, secures it and gives report to you that its a great working IV, but you find the IV in place with the needle still in the cath and tourniquet on... seriously!

    Or, "I have great skills at starting IVs. I know I do, because I have done many butterflies before in my other job, and it must be like that." And after asking how many IVs this nurse has done... "Well, none really. It looks really easy." And when asked about how many times this person has done peripheral blood draws... "Well, I haven't worked in 5 years, but I did a few and did a good job." I did not belittle this individual, but reminded them that IV therapy and peripheral blood draws are nothing of the same.

    Or, after 15 weeks of orientation (typically given 4-8), a nurse still looks puzzled when a doctor orders an accucheck on a known diabetic.

    Just some things like this, that experienced nurses "should" feel comfortable with is challenging for preceptors. Not that there is room for improvement, because there certainly is, but that episodes like these mentioned above are mentally draining. It takes strong expereienced preceptors to hod on tight for the crazy ride at times without pulling hair out
    mybrowneyedgirl likes this.
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    If they can't get past the "I need an order in the computer first" before being willing to intervene in an urgent situation. Understandable at first, but not being able to learn to trust your team in the long run is a problem.
    brillohead and canoehead like this.
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    Quote from JBudd
    If they can't get past the "I need an order in the computer first" before being willing to intervene in an urgent situation. Understandable at first, but not being able to learn to trust your team in the long run is a problem.
    I can see where on the floor not having an order is an issue (just reading some of these posts where docs won't sign phone orders!) but in an ER with 5 million people who all hear the verbal order....well, you are covered, just give it!
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    Quote from Heavenlee75
    A lot of nurses forget that at one time they too were new...I have a huge problem with nurses who think they're better or smarter than the next! I'm an experienced nurse who has oriented new nurses and student nurses and I enjoy teaching. The ER is a stressful place and although it might not be for everyone nobody should ever be made to feel like they're a burden to other nurses because they're new. That's why nursing is so stressful these days...bad attitudes to others!!!
    Heavenlee75, I'm right there with you on this! I've watched several new grads crash and burn after their orientation which consisted of their preceptor and the preceptor's buddies belittle every question or difficulty their preceptees had. I personally believe that the "old eating their young" really applied in this setting. It was really unfortunate considering a lot of these new grads had really solid assessment and critical thinking skills, but chose to move to other units because they were so miserable and intimidated. These "seasoned" nurses were notorious for making their own mistakes, including letting septic pts ivf's run dry, not giving abx's when ordered, and running pressors either at the incorrect rate or incorrect concentration because they were so busy sitting on their lazy **** and making fun of everyone else! But in the end, you reap what you sow; from what I hear, now the ED's so understaffed, and most are looking for new jobs.
    While I get that some people aren't cut out for the ED, "newbies" should be given every opportunity to prove that they can pull their own weight with the proper preceptorship and unit resources when they're cut loose. IMO.
    Last edit by Esme12 on Jan 29, '13
    AnGG, Armygirl7, Nursingluv101, and 3 others like this.
  7. 1
    Quote from JBudd
    If they can't get past the "I need an order in the computer first" before being willing to intervene in an urgent situation. Understandable at first, but not being able to learn to trust your team in the long run is a problem.
    I'm getting better at that. Now for a ACLS or trauma situation, there's no time to put orders in the computer. But it seems many doctors are too damn lazy to put in orders on non-urgent patients, so they give a verbal order. I'm learning which doctors I can trust, and which doctors I can't trust easily.
    MBARNBSN likes this.
  8. 0
    Quote from XmasShopperRN

    Heavenlee75, I'm right there with you on this! I've watched several new grads crash and burn after their orientation which consisted of their preceptor and the preceptor's buddies belittle every question or difficulty their preceptees had. I personally believe that the "old eating their young" really applied in this setting. It was really unfortunate considering a lot of these new grads had really solid assessment and critical thinking skills, but chose to move to other units because they were so miserable and intimidated. These "seasoned" nurses were notorious for making their own mistakes, including letting septic pts ivf's run dry, not giving abx's when ordered, and running pressors either at the incorrect rate or incorrect concentration because they were so busy sitting on their lazy **** and making fun of everyone else! But in the end, you reap what you sow; from what I hear, now the ED's so understaffed, and most are looking for new jobs.
    While I get that some people aren't cut out for the ED, "newbies" should be given every opportunity to prove that they can pull their own weight with the proper preceptorship and unit resources when they're cut loose. IMO.
    And I agree 100% with what you said...I watched one nurse who was super intimidating to new nurses but couldn't even spell good :-/
    Last edit by Esme12 on Jan 29, '13
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    Lol, am I the only one who noticed the context of that previous post and giggled a bit? 'Couldn't even spell good'? :P
    Sorry, no offense meant, just a Monday morning brain fart.
  10. 0
    Quote from libran1984
    When the noob administered PO benadryl IVP and called the diphenhydramine an abx.

    ....

    I don't know much else.... just something i heard.
    Eeek!! Was it liquid or pill/capsule form and did the pt live???
    WOW!!!

    BeLLaRN


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