What do experienced nurses expect from new nurses?

[alabama2]

Hi,

I am just starting in a BSN program and would like something feedback from those of you who are already in the field. What is it that you wish new nurses were better prepared for? Is there anything that the recent graduates you work with seem to be lacking in training? Whether it is technical knowledge or bedside manner, please let me know what you think.

Thanks,

[mariedoreen]

I thought as a new nurse I had to be able to handle ANYTHING and EVERYTHING. Talk about scary. In our last semester an instructor told us to always remember that we are not an island, that there is a world of help around us. I remember when it really hit home for me: I asked an RN during orientation what would be expected of me as a new nurse during a code. She looked at me and said, can you do compressions? Well, of course. Okay, she said, then those who know what they're doing will do everything else, and eventually, with experience... you'll become one of those people.

As a new grad I was gauging my readiness for being on my own on how many questions I had to ask during my shift. When the DON figured out why I wasn't comfortable with exiting out of orientation she told me that I would have questions for the rest of my career and that was not an adequate reason. I like that they expect me to feel unsure, to ask questions, to not know everything. I've learned that as long as I know when to ask and do it, as long as I make a concentrated effort to learn and practice my skills whenever possible, then everything's ok.

I'm not shy about who I ask either, CNAs, other nurses, the charge nurse, respiratory therapy, physical therapy, pharmacy, MDs... if I think they can help me and they're moving slower than I am, then they're IT. I just make sure to give pertinent info only and ask that question fast, cause they're busy too.

[csiln]

Hate to always be the "Eoyore" but they ate me alive when I asked questions or, heaven forbid, had never done something!! Where are all you nurses that are so supportive to new grads -- I'd live in somebody's basement to be able to work with some of you!

[jkw_83RN, BSN, RN]

I'd have to agree with previous posts. Being humble and attentive to your surroundings go a long way. Do not be afraid to ask questions or ask for help when needed. Be a team player. Do not act like you know it all because no one does. Pay attention to details so the same mistake won't happen again. And have a positive attitude. Know yourself and what your limits are.

[ZASHAGALKA, RN]

Just to sound agreement: there is a world of difference between 'book' learning and real OJT learning. Don't presume that you know everything and don't try to 'impress' experienced nurses with all your knowledge. You'll just come off as haughty and it will lead to experiences that YOU will interpret as 'being eaten'.

Nursing school doesn't teach you how to be a nurse. It arms you with the tools to LEARN how to be a nurse. That is OJT learning, for all of us. And that takes time.

I'm not afraid of new nurses that don't know everything. I'm afraid of new nurses that DON'T KNOW what they DON'T KNOW. I'm afraid of the ones that have such a chip on their shoulders to prove their knowledge base that they get in way over their heads and won't ask for help.

Stages of critical thinking:

Unconscious incompetence: don't know everything they need to know, and don't know they don't know.

Conscious incompetence: don't know everything they need to know, but realize when they don't know.

Conscious competence: normally knows everything they need to know, and normally know they know it, and why.

Unconscious competence: normally knows everything they need to know - and more, even if they don't always know why.

These last nurses, they are the ones that can look at a pt and go, "Something's not right." They might not know WHY, but they know to start looking. . .

What do I expect? I expect that you graduate from unconscious incompetence to conscious incompetence AS SOON AS POSSIBLE. I will start trusting you long before you are fully competent IF I have confidence that you will seek help when you need it.

Going from being a student to being a nurse is a wake-up call. It's a tough terrain to navigate. We've all been there. Take a deep breath, and respect your contribution.

Learning to navigate the trenches takes time. Everyday is an investment in the experience that will make YOU the nurse with expectations for new nurses. Just take it one shift at a time. Before you know it, you'll grow your comfort zones large enough to BE the experienced nurse you want to be.

Good luck.

~faith,

Timothy.

[ZASHAGALKA, RN]

Hate to always be the "Eoyore" but they ate me alive when I asked questions or, heaven forbid, had never done something!! Where are all you nurses that are so supportive to new grads -- I'd live in somebody's basement to be able to work with some of you!

Be positive, assertive and persistent.

It's a hard job and even though the experience mix is SUPPOSED to be there so that new grads have resources, in many cases, this is a job that can burn some out. It happens all too often.

Find the long term mentor or two that you CAN learn from and ask those questions that need to be asked. They are there, even if you have to 'cultivate' them for the job.

And work on being helpful yourself. If a nurse needs a turn, or other asst, you BE there. Even the hateful ones. And be there was a cheery disposition. This is EXACTLY where the 'turn the other cheek' concept applies. It's hard to turn down the requests of someone that is always willing to help YOU. Be that person.

You know, I've been a nurse for 13 yrs, and I STILL have nurses that are rude and pushy - towards me. I assertively set limits, and I keep a positive focus.

Remember this: Illegitimi non carborundum. It's a pseudo-latin phrase from WWII that WILL come up in a browser search. I first came across a similar phrasing in a great little book called 'The Handmaid's Tale' by Margaret Atwood.

~faith,

Timothy.