About New Grads

[Tweety, BSN, RN]

Our nuse educator on our floor is very critical of the new LPN grad on our floor for time management. She says she sets her standards very high and nearly impossible to attain for a reason, it motivates him to do better.

However, it is having the opposite effect of frustrating him that he can't reach her time management goals. Even more so when he sees the rest of us not achieving those same standards.

I'm the type of preceptor that allows new grads to be new grads, and to role model good skills. Good time management and critical thinking takes a long time. I would rather see someone do good assessments, know what meds they are passing, etc. rather than saying "by 10:00 you must be done!". I'm afraid he's going to cut unnecessary corners.

I do understand that time management and timely med passing and charting are goals to achieve.

I guess I'm frustrated because I told the educator this fellow is ready to come off orientation and work under the guidance of the charge nurse. She snatched him off of nights and put in on days with more orientation. He's been on orientation for 12 weeks. Experience is all he needs now.

What do you think. Set impossible goals? Or allow a person to find their own time management with experience, while gently nudging them to do better?

Anyway, I'm just babbling now.

[BadBird, BSN, RN]

I think the goals should be attainable within a reasonable amount of time. We must work together with new grads and guide them in the right direction not constantly critize and set impossible goals. Does this nurse educator just not like LPN's?

I don't think that setting a time of "by 10:00 all work must be done" is reasonable, if the nurse has good assessment skills, knows the rationale for the medications, and knows when to ask for help if they need it then it is time to let him fly solo, just be nearby incase he needs a extra hand as we all do .

[renerian, BSN, RN]

I think setting goals should be reasonable. After all you can scare someone away from the unit/facility and nursing all together if you put the bar so high no one can obtain it. I think leading by example is better.

renerian

[Stargazer]

The approach that my ICU preceptor used was to set reasonable, achievable short-term goals, and then help me to meet those goals. Once a particular goal had been reached, she would set the bar slightly higher--but still make it achievable.

One example: the first few times I got a set of Swan-Ganz numbers, it took me forever. Like, 20 or 25 minutes to remember to calibrate, get a wedge pressure, shoot a cardiac output, remember to turn all the stopcocks, do the calculations, etc. My preceptor observed this a couple of times and then said kindly, "Let's set a goal: within 4 weeks you'll be able to get a set of cardiac numbers within 10 minutes." Reasonable, achievable.

I first learned to suction a vented patient with another person bagging. Then my next goal was to learn to suction a vented patient alone. Then I learned to NT suction an unintubated patient with help. Then alone.

To be honest, 3rd Shift, the nurse "educator" you're describing sounds kinda lazy. Rather than do all the work of setting short-term goals and helping the LPN achieve them, she's simply saying, "Here's where I want you to end up. I don't care how you get there, and don't expect any help from me, just get there." I agree with you that her methods sound counterproductive. One would think that she could see by now that her methods aren't necessarily working, at least with this particular new grad, and could manage to be a little more flexible.

[OBNURSEHEATHER]

When I first satrted on my unit, I was paired up with a preceptor. I took over her routine, one patient at a time. Just when she felt I was doing good with 2, she'd give me another, and etc.

Setting someone up for disappointment and failure will only lead to burnout. This is an especially important concept for new grads.

Baby steps.....

Heather

[traumaRUs, MSN, APRN]

This is how nursing in general gets the reputation for eating their young. Be kind to people and treat them like you would want to be treated.

[Tweety, BSN, RN]

Good to hear from like-minded people. I will never forget how I felt being a new grad. I think we've already lost this one, he can't wait to get off of orientation and work for a while so he can quit and move on. Too bad.

[MishlB]

I think "they" sometimes forget that they were once students!!!!!!!

[firstyearstudent]

It's in a facility's best interest to be supportive to new grads. I just graduated and the quality of the new grad program as well as the hospital's culture and reputation were #1 in aboout 90% of our minds. I've know at least two news grads who quite during or shortly after orientation to re-do new grad orientation at another hospital.

[CRNA2BKY]

Your nurse educator should NOT be in that position!!! It is absolutely incredible to think that management would keep in her in contact with new grads, and she should be removed immediately. I have been involved with education for many years, and this is definately not the way to treat new grads. She is sick.

[Tweety, BSN, RN]

Thanks for the responses. This thread is almost five years old. The guy wound up staying a year and doing really well despite the unrealistic expectations. He only worked part time and took another job somewhere else.

I have long since left this unit myself.

[Roy Fokker, BSN, RN]

I was pushed. And pushed. And pushed. During my orientation. My preceptor was an awesome task master.

But she'd constantly tell me "I don't want you to think I'm being a nag". Or "I don't want it to appear like I'm just riding you. But you have to learn to do things more efficiently. It's a delicate job and you're making great progress. You'll get there. I know it seems like it is impossible now but trust me, I know you're getting there".

Or she'd say "We need to work on the issue of you checking for new orders and signing off. How about we try this? Why don't we...."

And the thing that I liked the best - was that she'd stay over late whenever I got delayed. She'd stay over to help with my charting and to go over my charting. She insisted that I get my breaks - even when I was behind on some work.

She was always open to questions - her motto being "Better to ask me the same question a 1000 times than not ask me and end up making a mistake".

She told me on Day 1 - "You're a new grad nurse. I don't expect you to have the knowledge and proficiency of an experienced nurse. However, I DO expect you to try your best and work hard. I'm hard, but I am also fair. This isn't an easy job but it can be a very rewarding one. It's all in your hands and in the attitude you bring to work every day."

She never let me slack off, even for one single day. On days when our census was low, she'd make me pick up extra patients from other nurses - or have charge nurse reassign patients so that we were up to full load.

And to this day, I credit her for doing what she did to whip me into some shape so that I could face loads of up to 8 patients and not break.

Realistic goals are important. Any new grad is going to feel horridly overwhelmed - and it's important to recognize that. The whole "Everything must be done by 1000 hrs" is absurd and wholly unrealistic - especially when you point out that many times experienced nurses themselves have difficulty meeting that goal!

cheers,