For myself as a new grad on a floor and prone to going "deer in the headlights" myself, I could have used more structure. I often saw several different way to approach the patient load but had no way to determine how to choose a plan of action. So I'd waver, looking for some guidance on how to prioritize and get started, only to be told "I needed to be more independent." If I sat down and made a checklist, I was too slow in getting started. If I didn't, I was too disorganized and should "keep a list". It felt like damned if I do, damned if I don't.
I needed some training wheels to get started. Some people just don't work well with a pre-set plan and for those folks, don't force it on them. But I find them very useful. Once I'm up and running I have no problem tweaking the plan, or even creating a whole new one, but when I'm getting started at anything, I like to start with structure. So I could have used a very clear plan of attack that my preceptor supported... such as 1) quick round on patients 2) check vitals 3) check in with NAs 4) a set format checklist 5) pass meds. Only life threatening emergencies and maybe a few specific other situations would warrent changing that game plan - at least until the new grad had enough experience to make the call themselves.
Also, experienced nurses know there's barely enough time to do all that needs to be done, so they're often rushing off at the beginning of shift, automatically organizing everything in their head and, me, the new grad, only sees them rushing in and out of rooms and isn't learning what exactly the experienced nurse is doing. The preceptor also knows right off what to do and what to take care off and hates to see the new grad "wasting time" fumbling along or being slow to respond to something the experienced nurse would jump on immediately. So when the preceptor steps back and sees the new grad taking 20 minutes to check in their patients and not being sure where to start after that, they "helpfully" let the new grad that they need to "be faster" and "learn to proritize better."
To me, it's useless to say "You need to work smarter and faster" or "you need to learn to prioritize better" or "you need to be more organized." I realize that. The question is HOW? And you can't seriously expect me to get it all together in a few weeks when experienced nurses are still struggling with some of the same issues.
I also suspect many nurses run more on gut than on conscious deliberation, and can't always give concrete, clearly articulated reasons. That doesn't mean they don't know why they do what they do, but it's so second nature at that point it's hard to explain. Even if they could, they don't have the time to do so because the way it's set up, nurses don't have a minute to spare to review a specific case and go over it with the new grad to review how decisions were made.
The sink or swim philosophy of nursing would be fine if there were tons of qualified people to compete for the positions. But we need LOTS of nurses so it makes sense to provide some swimming lessons for those who don't immediately take to nursing like a duck to water. And while maybe nursing schools
should better prepare students for the "real world," we have to work with things the way they are.