New grads being rushed into "nursing maturity"

[PA_RN87]

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 responsibilities that traditionally are more "appropriate" for nurses with a little more experience. This coincides with hearing several stories by new nurses who were pushed off of orientation early, given a shortened or unstructured orientation, or no orientation whatsoever.

I would ask why the big rush to have new nurses function on the same level as nurses with years of experience, but I already know the answer - finances. They're paying you to work as a functional team member, and expect you to preform according to your payscale. Fine - I get that - but at what point do we cross the line where the costs outweigh the "cost benefits?" Pushing new nurses too quickly leads to problems on the patient side, and on the nurse side. Patient safety is put on the line by overtaxing a new nurse with extra patients, longer hours, or more responsibilities. Nurses are "burning out" quicker or quitting before they hit the 6 month mark.

None of these things are healthy even with experienced nurses, so I don't mean any disrespect for those experienced nurses who struggle with the same situations. However, new nurses aren't as "seasoned" and are more likely to make a mistake or burn out quicker.

Personally, I'm barely into my 4th month (including orientation), and I've been given more than the "maximum" patient load, expected to join committees, floated to 4 different units (despite being told new nurses aren't floated until after 6 months), and taken advantage of with scheduling.

Just opening this up for a general discussion. I'm interested in everyone's personal stories relating to the topic, as well as your views and opinions.

[SRNA4U, BSN, DNP, RN, CRNA]

And the worst thing after having to deal with mean nursing staff, if you decide to work in the ICU, you'll see that having to navigate through the various personalities makes working in this area very hostile as well. In the ICU, it seems everyone is out to prove who knows the most in regards to their knowledge base. Some of these nurses are the most arrogant and cocky people I have ever worked with, which is unlike many of the other nursing specialties. I also work as an OR nurse and even though we work in our own rooms, we tend to help each other out for the most part. Working med-surg, nurses just try to make it through their shift with their 6-9 patients, which is what I had to care for when I worked civilian med-surg. In the ER, we all work as a team when an emergency intervention is required but I must admit, working in the ICU has been the one area where people are out to just out-do each other. Everybody is trying to get into CRNA and some of the new nurses in the ICU you can't even tell them anything because they think they know so much. When we work as charge nurses, we often give those nurses the heaviest patients just to see if they can back up what they brag about in regards to how much we know. We even had one nurse trying to teach someone how to use the balloon pump when he hasn't even been oriented to the heart team.

I'm glad I'm in CRNA school but to any person considering working in the ICU, please beware of the personalities you will have to deal with. I have never seen the level of backstabbing and the putting down of nurses by their co-workers in this area. I have been in nursing for 15 years starting from an ADN program where we had to care for 6 patients during our last semester by ourselves without help from our preceptors so I felt well prepared for the challenge of working med-surg. Back in the day, I remember driving to the clinical location the night before just to get my assignment so I could complete my care plan the night before. Nowadays, with the fast discharging of patients, I think nursing schools now are assigning students their patients the day of clinicals.

[pumpkinspice555]

That's just sad how some nurses go out of their way to put others down in order to feel good about themselves. Because of the many different personalities (a lot ugly, but not all) is the very reason why I don't want ICU! At least not as a new grad. But once I get more experience in med surg, maybe I'll be open to going there. I just don't have an ICU quick paced know everything right now personality....

[elkpark]

We need to lobby Congress to initiate bills which will limit the number of students churned out each commensurate with the number of expectant retirees and nurses expected to leave the field to pursue other interests, thereby lessening the glut instead of increasing it.

(Congress has nothing to do with this, and no control over what states do re: nursing education.)

[FMF Corpsman, MSN, RN]

And the worst thing after having to deal with mean nursing staff, if you decide to work in the ICU, you'll see that having to navigate through the various personalities makes working in this area very hostile as well. In the ICU, it seems everyone is out to prove who knows the most in regards to their knowledge base. Some of these nurses are the most arrogant and cocky people I have ever worked with, which is unlike many of the other nursing specialties.... but I must admit, working in the ICU has been the one area where people are out to just out-do each other. Everybody is trying to get into CRNA and some of the new nurses in the ICU you can't even tell them anything because they think they know so much. When we work as charge nurses, we often give those nurses the heaviest patients just to see if they can back up what they brag about in regards to how much we know. We even had one nurse trying to teach someone how to use the balloon pump when he hasn't even been oriented to the heart team.

I'm glad I'm in CRNA school but to any person considering working in the ICU, please beware of the personalities you will have to deal with. I have never seen the level of backstabbing and the putting down of nurses by their co-workers in this area. I have been in nursing for 15 years ...

I'm not exactly certain where to start, but since you decided to unload on my particular specialty with both barrels, start I will. I'm interested in what exactly you might consider your own personality, since everyone else in the ICU were deemed to be so hostile, especially since you later go on to include yourself in "their typical actions as Charge Nurses," like assigning the heaviest load to nurses who brag so much, just to see if they can back up their mouth's. You also state/complain that everyone there is trying to get into CRNA and yet you can't tell them anything because they already know so much, yet you come back later in your post to tell us that YOU ARE GLAD TO BE IN CRNA school. I'm glad you are as well. Hopefully, that will be a good fit for you. But I have a question, What is so wrong about teaching someone how to use the "Balloon Pump?" it doesn't matter if s/he is oriented to the Heart Team, Trauma Team, or the Olympic Team. You may or may not remember this, but they use to say the same thing about the Defibrillator. It was a highly specialized piece of equipment and only Medical Doctors could ever be taught to use them. Teaching someone how to use something doesn't take anything away from you, in fact, it might actually help you one day, you never know. It doesn't mean that they are now certified in its use, or even oriented to the Heart Team. It simply means he might have basic knowledge on how the machine works.

As far as personalities in the ICU, I'll grant you most of them are type A, but that's exactly the type of person that is needed to do the job. Anyone who has been there for a while is definitely a type A; otherwise, they wouldn't have been able to handle the stress. Other personality types simply cannot deal with the types of trauma they are continually bombarded with day after day and expected to treat them and move on, regardless of their own feelings. People whose brains are pouring out of the side of their crushed skulls from a MC vs. Tree, crash without a helmet, in the next bed may be a former coworker who has suffered a stroke. The Unit is filled with cases such as these day after day, week after week and the staff must grin and bear it. Is there any wonder they might not always have such rosy personalities all of the time or deal with people they aren't familiar with in more than a cursory shrug? Critical Care and Trauma Nurses tend to be guarded and aloof, they aren't always accustomed to having to deal with people who are perpendicular. Give them a coma patient or someone in need of a great deal of care and then you will see the love and compassion.

[FMF Corpsman, MSN, RN]

(Congress has nothing to do with this, and no control over what states do re: nursing education.)

Actually, I beg to differ with you. The State Legislatures could play a pivotal role in the number of students that the indivual schools allow to graduate each year. The State Legislatures would then simply pass on to the Board of Education the new GUIDELINES, and fewer students would utter forth onto the job markets.

[elkpark]

Actually, I beg to differ with you. The State Legislatures could play a pivotal role in the number of students that the indivual schools allow to graduate each year. The State Legislatures would then simply pass on to the Board of Education the new GUIDELINES, and fewer students would utter forth onto the job markets.

Yes, the state legislatures do play a role. Congress does not.

I have a hard time imagining anyone convincing a state legislature that fewer new nurse graduates each year would be a good thing. They and the state BONs are usually under significant pressure from a variety of stakeholders to increase the number of available "slots" in nursing programs each year and the overall number of nurses in the state.

[LadyFree28, BSN, LPN, RN]

Yes, the state legislatures do play a role. Congress does not.

I have a hard time imagining anyone convincing a state legislature that fewer new nurse graduates each year would be a good thing. They and the state BONs are usually under significant pressure from a variety of stakeholders to increase the number of available "slots" in nursing programs each year and the overall number of nurses in the state.

However, like Corpsman stated, if there was a way to get other parties involved; it doesn't do a state ANY good with unemployed nurses...especially new grads, or potential nurses who have been delayed a start in the field, decreasing favorable outcomes, which these factors ALL have a monetary stake, even for those stake holders who have an "interest".

[PMFB-RN, RN]

The only problem with having an internship on nights is that there are far less procedures and therefore less learning opportunities in your average hospitals, then than there are on 3 to 11 and especially on 7 to 3. Or for those on 12's, 7a -7p. For those fortunate enough to be interning in Level One trauma Facilities, it might be a different story, but even then, chances of newbie's landing fresh traumas are few and far between there as well, and whoever does, isn't going to have the spare time to mentor a student or intern. However, the schedules may very just enough that they can get in more treatments and procedures on the other patients than those in lower status hospitals and LTC facilities.

Schools' cranking out far too many students has been a problem throughout the ages or at least since I was in school and graduated. My graduating class numbered 92 and we started with 130. A few years later someone started the never ending rumor that there was a nursing shortage, and it was true for a while, but it soon abated, but the schools keep turning out student nurses like a mother rabbit turns out babies, please do not take offense at that anyone, as I mean it in the best possible way. But there is now a glut of nurses and the ability for nurses to negotiate with HR or Administration effectively is non-existent, which leaves us with fewer benefits and at lower salaries in many areas of the Country. I know most of the Country is going through dire straits right now, but we started out at a lower place on the grid to begin with, so when the economy rebounds we will still be lower than most. We need to lobby Congress to initiate bills which will limit the number of students churned out each commensurate with the number of expectant retirees and nurses expected to leave the field to pursue other interests, thereby lessening the glut instead of increasing it.

Of course that word leave Congress very confused since they have been lobbied for years for money to expand and create nursing programs to fix the "nursing shortage".

[FMF Corpsman, MSN, RN]

Please, excuse me if my comments offend you, they aren't intended that way. I am certain things are much improved from the way they were many years ago and attitudes have changed significantly for the better and after a great deal of hard work. Years ago when I first joined the nursing force, men were few and far between back then and I was often treated as if I were a work horse, only around to lift patients in and out of bed or for much needed brawn if a patient were to get rowdy and out of control, handy to do the male caths, you get the picture. All of this on top of having my own patients to care for. This was a female dominated career field and if I wanted to get along with any hope of progressing, I needed to go along to get along. I was also in school and working full time. One thing I noticed was that the nurses usually got the short end of the stick as far as pay, benefits and other enticements were concerned, such as weekend differentials, uniform allowances, tuition reimbursements, paid ceu's. Yet know one was willing to speak up about it or if they did, they were threatened with termination. No one was willing to listen to a female. They didn't respect the voice at the time. There were very few Nursing Organizations with any clout and if any tried to establish themselves they were shut down by Administration and the instigators were terminated and blackballed. Sadly, today the Nursing field is still way behind where it should be because of it's late start, and male dominated professions enjoy salaries, benefits and other perks nurses won't come to enjoy for another 20 years. All because women aren't/weren't willing to speak up and demand what should rightfully be theirs. The old saying that "women should be kept barefoot and pregnant," has been utilized by male chauvinist for years to keep women down and "keep them in their place." I love one of the signatures that Esme12 uses on her posts, "No one can make you feel inferior without your consent".... Eleanor Roosevelt. I love it because it is so very true and it is a great affirmation, whether it is someone on your unit, a Physician who does rounds on the unit and always bust your chops, your Unit Manager or even just another team member, you have to let them put you down and only you have the power to stop them. As far as your career goes, only you can make it go better too. I made the changes in my own career path that I needed to make and ended up where I called the shots on the very units where I once worked lugging people out of bed, guess what, I still had to help get people in and out of bed. Nursing is nursing and some things never change. Lol. But, there are things that we can change if we work together to change them, they'll never change if we simply set around and say we need for change to come about and let it go at that. It's like the Chinese Proverb. "Give a basket to two people, Which do you think will get full faster, One who sits and merely wishes or One who gets up, goes and fishes? Lesson being, you have to act.

[elkpark]

However, like Corpsman stated, if there was a way to get other parties involved; it doesn't do a state ANY good with unemployed nurses...especially new grads, or potential nurses who have been delayed a start in the field, decreasing favorable outcomes, which these factors ALL have a monetary stake, even for those stake holders who have an "interest".

It may not do the state any good; but it does healthcare employers in the state a lot of good, in the sense of keeping wages down and employed nurses fearful of losing whatever crummy job they may have, and healthcare employers in a state typically have a lot more clout with state legislatures (as well as the US Congress) than nurses do.

[FMF Corpsman, MSN, RN]

It may not do the state any good; but it does healthcare employers in the state a lot of good, in the sense of keeping wages down and employed nurses fearful of losing whatever crummy job they may have, and healthcare employers in a state typically have a lot more clout with state legislatures (as well as the US Congress) than nurses do.

Unfortunately, the State is usually going to side with the business interest over that of the employees, as they tend to share a mutual interest. Which was the point of my previous post. The more Nurses that can join together to make a collective voice, the stronger and more powerful they become. This can be accomplished in the form of a Lobbyist in the State Capital, Unionization, a strong Nursing Organization, anything that can form a cohesive voting block with huge numbers, can effect change. Sitting around and wishing for it, will get you nowhere.

[elkpark]

Unfortunately, the State is usually going to side with the business interest over that of the employees, as they tend to share a mutual interest. Which was the point of my previous post. The more Nurses that can join together to make a collective voice, the stronger and more powerful they become. This can be accomplished in the form of a Lobbyist in the State Capital, Unionization, a strong Nursing Organization, anything that can form a cohesive voting block with huge numbers, can effect change. Sitting around and wishing for it, will get you nowhere.

This same conversation was in full swing when I was in nursing school 30 years ago, and not much has changed, despite the sincere efforts of lots of good nurses. My own experience over the all these years has been that nursing is its own worst enemy. Since we are the largest block of healthcare professionals, we should (and could) be running healthcare, and making most of the key decisions. However, trying to get nurses to agree on anything, and work together to pursue the interests of the larger nursing community, is like trying to herd cats. I used to be quite the firebrand and activist myself, but a few decades of frequent and repeated failure and disappointment will grind most anyone down eventually.