New grads being rushed into "nursing maturity" - page 3

by PA_RN87 8,732 Views | 67 Comments

Based on several threads that I've read on here, and on my own personal experiences as a new nurse beginning my 4th month of experience, I'm seeing a general trend towards rushing new nurses into experiences, roles or... Read More


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    I totally agree that the lack of quality in nursing education is largely to blame. My program was an entry level masters, and the quality of my clinical experiences weren't good at all. As mentioned, there where a lot of restrictions on what students could do. Our nursing instructor had up to 12 students at a site. On top of that, the nursing instructors that I got were not nice people, and seemed to really want to humiliate their students.

    With the exception of a few good floor nurses that I got to work with, most floor nurses didn't have the time or desire to teach students. Many were downright rude to me.
    *** I am sorry that was your experience. There isn't any excuse for nurses to treat students that way. However you may have been a victim of the wide spread bias against the program you chose.
    I have often heard discussions among nurse preceptors about the superior attitude and lack of interest in learning basic nursing skills among DE MSN students. I have experienced this myself. However each student should be taken as an individual and not judges by the attitudes and actions of their fellow DE MSN students.

    My final senior preceptorship was terrible too, because the nurse who was my preceptor for 200 hours didn't want to teach a student, so she pretty much used me as a nurses aid. She even told me her nurse manager said that if she took a student then she'd get a raise, and that was the only reason she did it. It was a very uncomfortable situation. The other nurses on that unit were not any more welcoming either.
    *** I precept nursing students nearly every shift. I get students from all kind of programs, including DE MSN. My students are either placed with me as part of a critical care class in the case of DE MSN and certain BSN students, or doing their senior preceptorship in the case of ADN and certain BSN students and spend 6-10, 12 hours shifts with me on the rapid response team. I have to admit that the DE MSN students are often different and I sort of dread taking them. However I try to judge each student as an individual.

    Since that time, I have been a RN now for one year, and can't find a hospital job in California. I have been working at a SNF facility. I am learning more there than I did during any one of my clinicals. But none the less, many of the LVNs at that facility are very nasty and not willing to help new nurses.
    *** Do the other new grads from ADN and BSN programs face the same treatment?
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    Quote from llg
    Adding to what the previous posters have said (great posts, BTW) ...

    I believe another thing that should happen is that we need to change the pay scales so that new grads make less money while they are on orientation and not "pulling their weight" on the team. That's part of the problem. Employers aren't willing/able to pay for the expensive on-the-job training required by new grads while paying them as if they were functioning at a full professional level. But so far, that idea has not been culturally acceptable within nursing.

    I know that idea is controversial, but nurses can't have it both ways. If people want to be paid salaries close to what nurses with 2 or 3 years of experience make, they need to function at that level and "be worth it" to the employer. If they need 6 months to a year of special training, reduced responsibilities, etc., they have to expect to be paid less. Medical residents and fellows make considerably less than attending physicians, law firm associates make a lot less than partners, etc. New school teachers are on the same pay scale as experienced ones, but they are assigned their own classrooms on Day #1 with NO preceptorship time. Nursing needs to decide which model they want to use -- the one in which new grads are ready-to-go on day #1 and deserve a full professional salary ... or the one in which the new grads needs additional training and transition time and does not deserve a full professional salary. We can't have it both ways.

    This idea is particularly pertinent because of the high number of new grads who plan to work in the first job for only a year or two before moving on to something else. Why should an employer provide a full professional salary + a lot of expensive education to someone not functioning at a full professional level who does not plan to stay in that job long enough for it to be a worthwhile investment to an employer?

    We need to look at a new model ... with different pay expectations to match the level of responsibility new grads are prepared to take ... the type of training they need ... and the likelihood of their staying in their first job for a substantial period of time.
    I agree completely. What baffles me is while all of this is going on; some of those same nurses are trying to be assigned to the specialty units. If they aren't yet fully qualified to work on Med-Surg or Step-Down units, what on earth makes them believe they are even remotely qualified to work in a unit that requires specialized training in addition to a few years of experience? Can a fresh grad go into an ICU and successfully do open heart massage if it is asked of them without passing out at the bedside? I rather doubt it. That doesn’t happen everyday, but it does happen.
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    Quote from NY_teach
    The staffing model just wants bodies to get the work done. A nurse is a nurse is a nurse.
    I couldn't disagree with you more. Perhaps that is true in some facilities, but it is the absolute worst mistake they could make. Hiring only warm bodies instead of the best candidates, they can find, sets them up for failure and only poisons the staffing pool they already have with discord and discontent. "A nurse is a nurse is nurse is a nurse," is pure BS. Are you a Nurse or a teacher? Those without a calling to be a nurse don't stay in the field very long, and you can usually tell pretty soon, who they are, it isn't difficult. They turn their nose up at certain task, or make themselves scarce when it comes time to do certain things that are beneath them, they are the last to answer a call light, and they think that is always the LPN or aides job, even when they are standing right next to the room. They are quick to say, "Not my Patient," but get highly indignant if someone else, who is juggling 3-4 different things at the time, says the same thing about one of his or her patients. NO, you're wrong, a Nurse is definitely not nurse is a nurse. There is a whole world of difference.
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    Quote from scott5698
    Man, this hits it on the head! Poor clinical sites with absent teachers, teaching that amounts to "read the book, you're in nursing school", and real restrictions on what we can actually perform at clinicals. I am one of those second career individuals and I find the attitude of some of my younger classmates appalling, yet I know experience will usually teach them just how awful their attitude was. I'm tired of hearing how my previous 25 years of experience and degree don't matter. I WANT to do the best job possible, realize that I'm limited by my experiences and loyal to those who teach/train/prepare me for the real world. If only we could get the corporations to realize it.
    Scott I don't know how old you are, but there used to be a saying,”You get out of it, exactly what you put into it." or a similar concept,”You reap what you sow." If you wind up practicing in the same area where you went to school, you will likely find that those same lousy students will be lousy nurses, after they fail their boards a few times and eventually pass or either give up and go to work for Hooters or some other equally fine dining establishment. Keep striving to do the best job possible and your results will be there own reward, and you will have a great career. "When you have a job you love, you never have to work a day in your life."
    GrnTea likes this.
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    Quote from FMF Corpsman
    I couldn't disagree with you more. Perhaps that is true in some facilities, but it is the absolute worst mistake they could make. Hiring only warm bodies instead of the best candidates, they can find, sets them up for failure and only poisons the staffing pool they already have with discord and discontent. "A nurse is a nurse is nurse is a nurse," is pure BS. Are you a Nurse or a teacher? Those without a calling to be a nurse don't stay in the field very long, and you can usually tell pretty soon, who they are, it isn't difficult. They turn their nose up at certain task, or make themselves scarce when it comes time to do certain things that are beneath them, they are the last to answer a call light, and they think that is always the LPN or aides job, even when they are standing right next to the room. They are quick to say, "Not my Patient," but get highly indignant if someone else, who is juggling 3-4 different things at the time, says the same thing about one of his or her patients. NO, you're wrong, a Nurse is definitely not nurse is a nurse. There is a whole world of difference.
    I don't think NY_teach was actually saying s/he agrees with that pronouncement. I think the comment was more to explain the HR view of things. And trust me, HR really only cares about having a name attached to a shift. Of course the notion that "a nurse is a nurse is a nurse" is false - we aren't the interchangeable widgets most lay people believe us to be. But I'm seeing the erosion of appropriate staffing picking up its pace on my unit where we're now having nurses with ZERO critical care experience being floated to our high-acuity PICU on a routine basis now. The regular staff members are too busy with the sickest and most complex patients to watch over and support the floats and it's a disaster in the making. But this is how our administration has chosen to deal with the high turnover, high sick time and short-staffing ever-present on our unit. After all, "a nurse is a nurse is a nurse", right?
    Gentleman_nurse and FMF Corpsman like this.
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    Quote from FMF Corpsman
    I agree completely. What baffles me is while all of this is going on; some of those same nurses are trying to be assigned to the specialty units. If they aren't yet fully qualified to work on Med-Surg or Step-Down units, what on earth makes them believe they are even remotely qualified to work in a unit that requires specialized training in addition to a few years of experience? Can a fresh grad go into an ICU and successfully do open heart massage if it is asked of them without passing out at the bedside? I rather doubt it. That doesn’t happen everyday, but it does happen.
    I had read several posts on other threads that refer to the quality of RN clinical training having decreased, but I was still shocked to read on this thread of some people's nursing school clinical experiences. It seems appalling to me to pay tuition (often very large sums) and graduate from nursing school saying you received poor quality clinical training and that your school didn't properly train you to be a nurse. As another poster on this thread pointed out, providing extended nursing education is very expensive for employers, but the new grad is left high and dry with insufficient clinical training in nursing school. The posters on this thread who referred to the deficiencies in their clinical training are aware deficiencies exist, but, (and I am enlarging my comments now to all of the posts that I have read on these boards) often it appears some new nurses, from some of their comments that reference aspects of their nursing school clinical training or from other comments they make about nursing clinical practice, do not really understand that they have not received adequate clinical training in nursing school. To me this is very concerning. I agree in general with your observation of the incongruity of not being fully qualified to work on med-surg or step down units yet believing one is qualified to work on a specialty unit.
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    Thanks JanFRN, Nothing will get me more agitated than that phrase and before I retired, I used to go thru long dragged out fights with HR and the Nursing Supr. who were trying to staff my unit with "warm bodies" just to meet quotas. I can't count the number of evenings and nights regular staff had to pull doubles, of course then came the over time wars, just to staff the unit. I just don't believe in leaving patients with extremely high acuities with unqualified staff. There is nothing anyone can say that will justify making those decisions. HR is staffed with non-medical personnel and the House Supr's are usually not critically trained nurses, so aren't capable of making those types of decisions either. They are administrators in their current position, not nurses, which is why I resigned my position as an administrator, I didn’t like the position it put me in and I missed the patients and my Unit. NY_Teach, if I read you wrong, I'm glad, I was certainly hoping I was mistaken. Thankfully I didn't call you any of those nasty names, LOL.
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    Thank you janfrn for your support.

    To clarify my previous post FMF Corpsman, some organizations view all licensed nurses as equal in knowledge, skill, and abilities. It's a management model to labor. It doesn't matter if we're talking about nurses, teachers, or widgets makers. The worker is considered an interchangeable part in the organizational machine. To this type of manager, providing training to someone who is already trained doesn't make sense.

    I never said I agreed with it nor do I.
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    Quote from FMF Corpsman
    I agree completely. What baffles me is while all of this is going on; some of those same nurses are trying to be assigned to the specialty units. If they aren't yet fully qualified to work on Med-Surg or Step-Down units, what on earth makes them believe they are even remotely qualified to work in a unit that requires specialized training in addition to a few years of experience? Can a fresh grad go into an ICU and successfully do open heart massage if it is asked of them without passing out at the bedside? I rather doubt it. That doesn’t happen everyday, but it does happen.
    *** Of course new grads SHOULD be going into specialty units. Saying they should spend a few years in med-surg first is as silly as saying that a orthopedic surgeon should spend a few years doing family practice.
    Of course they will require more training but experience as a med-surg nurse usually isn't valuable for ICU and other specialty units, and we (my hospital) has some data that shows it may well be harmful.
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    Quote from PMFB-RN
    *** Of course new grads SHOULD be going into specialty units. Saying they should spend a few years in med-surg first is as silly as saying that a orthopedic surgeon should spend a few years doing family practice.
    Of course they will require more training but experience as a med-surg nurse usually isn't valuable for ICU and other specialty units, and we (my hospital) has some data that shows it may well be harmful.
    I'm afraid this is turning into a discourse where some of us will simply have to agree to disagree. I will never agree that a new grad should be allowed to cut their teeth in an intensive care unit as counted staff. If they are working under a Preceptor, okay, but not as a staff member, they simply do not have the required skills or the mental acuity needed to work in that capacity. If you think they do, then I question your judgment as well.

    Do you think that Certified Orthopedic Surgeons grow on trees? Yes, there are Orthopods that function in the field, but to be Certified or even before you specialize as an Orthopedic Surgeon, you have to start out somewhere in General Medicine. You don't graduate from med school as an Orthopedic Surgeon. To be Certified as an Orthopedic Surgeon you have to take the specialty Boards as I'm sure you know.


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